This topic is about Neil, who has been living with a colostomy since 2013. Recently, he's been experiencing issues due to a large parastomal hernia, which is causing him pain, discomfort, and problems with his ostomy appliance. His surgeon has suggested repairing the hernia and trying colostomy irrigation. If irrigation doesn't work, Neil might need to consider converting to an ileostomy. Neil is looking for advice on how effective irrigation might be for him and what to expect if he needs to switch to an ileostomy.

Here are some insights and advice that might help Neil:

1. General suitability and health requirements:
- Irrigation is generally recommended only if the remaining colon is in good health. It's important to confirm with a surgeon or ostomy nurse whether it's a suitable option.
- While a hernia can make things more complicated, it usually doesn't prevent successful irrigation.

2. Quality-of-life benefits:
- Many people find that irrigation allows them to go 48–72 hours without any output, reducing the need for daytime pouching and minimizing leaks.
- Those who have tried it report that irrigation significantly improves their daily confidence and comfort compared to standard colostomy management.

3. Equipment and brands:
- Commercial irrigation kits, like the Coloplast Irrigation Set, typically include a water bag, tubing, a cone, and a long disposable sleeve or bag. The sleeve can be worn during the procedure and left in place afterward as a safety pouch.
- One person shared a creative solution: using a garden weed-killer sprayer to provide a gentle, compressed water flow to navigate past a hernia-related blockage.

4. Procedure tips:
- Watching instructional videos on YouTube can provide helpful step-by-step demonstrations.
- Routine suggestions include:
- Best time: either first thing in the morning after a night of bowel rest or early evening.
- Frequency: every 2 days is common, though some people manage every 3 days.
- Volume: use the prescribed amount of warm water and wait about an hour for full return.
- Sit comfortably on a toilet, shower stool, or chair, and have a phone or book handy to pass the time.
- Drinking a cup of coffee or another warm beverage right after water infusion can help stimulate a more complete evacuation.
- Keep the irrigation sleeve directed into the toilet or a bucket for easy clean-up.

5. Managing hernia-related blockage during irrigation:
- Gently advance the cone, using light water pressure to help it bypass tissue folds caused by the hernia.
- Once the cone is in place, the initial resistance usually eases, allowing the rest of the session to proceed without pain.

6. Key take-away:
- If medically cleared, it's worth trying irrigation with a proper kit before considering a permanent ileostomy. Many people find that they can quickly master the technique, which may alleviate many of the current issues.