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Apr 20, 2025

Enema Through Ileostomy Stoma: Experiences and Advice

This topic is about dealing with a partial blockage in the small intestine, specifically for someone with an ileostomy. The person was advised by their doctor to use enemas through their ileostomy to help clear the blockage. They are seeking advice on whether this method is effective and what the experience might be like.

Here are some helpful suggestions and insights:

1. Try non-invasive measures first:
- Use gentle positions to relieve the blockage: Lie on your back, pull your knees toward your armpits, then drop your knees to each side for at least one minute while doing deep belly breathing to encourage intestinal movement.
- Apply manual pressure or massage around the stoma and use a warm or heated compress.
- Stick to clear liquids and avoid solid food until the blockage clears.
- Stay hydrated with carbonated drinks like room-temperature full-sugar Coca-Cola, Sprite, or seltzer, as many find the carbonation helps move the obstruction.

2. If an enema is necessary:
- Use a red Robinson catheter, which is a soft rubber tube, to introduce the fluid. This technique is accepted when a food bolus is stuck near the abdominal wall.
- Have a stoma nurse or physician demonstrate the procedure the first time to avoid injury and ensure the correct depth and pressure.

3. Precautions and when to seek medical help:
- Most small-bowel obstructions are due to adhesions, and enemas will not relieve those.
- If you experience worsening pain, vomiting, or if nothing passes within 24 to 48 hours on liquids, go to the Emergency Room.
- The lining of the small intestine is fragile, so forcing instruments or fluid can risk tearing and bleeding.

4. Diagnostic option:
- Instead of blind enemas, an ostomy specialist can perform a stoma endoscopy. This involves inserting a small camera under light anesthesia to visualize the bowel up to the level where the CT scan showed the obstruction, providing clearer information and peace of mind.
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