Irrigation Again - Help Needed

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Miss Scarlet

It is now 6 days since I started using irrigation. However, my colostomy continues to work all day after the irrigation. (It is great really because it did not work very often before.) However, I thought the irrigation would empty the bowel for 24 to 48 hours. I am irrigating every day with 1 litre of water. Does the bowel keep working because it has yet to get used to having water poured in or maybe I am not using enough water? Help.
Thanks
Maureen

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Pinky
Hi Maureen - Did you have your first session irrigating with the ET? The nurse usually tells you how much water your colostomy can accommodate. Many people use 1-1.5 liters, usually all at once, but I have read that in Europe some ETs recommend 500cc, empty, then 500 cc more.

My ostomy is a little unruly too - sometimes I think it depends on what you eat during the day - some foods make my ostomy run all day, especially fresh fruits (except bananas). Also, spicy foods, caffeine, and deep-fried foods can start things up. Bagels, toast, potatoes, pasta, and other starches tend to keep me "regular". And a banana each morning is a must for me.

I irrigate every 24 hours, but some on this site go 48-72 hours between irrigations. They will probably contact you after reading your post.

Good luck and don't give up! Irrigating is definitely worth it! ;Pam
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Past Member
I'm sure everyone will experience different results, and there is no "set rule". I typically irrigate in the evening and try to fast for 2 or so hours beforehand. For example, I get off work at 5 and eat when I get home...on the night I intend to irrigate, I would skip supper and irrigate at about 7 pm. I use 1.5 liters of water...be sure to use the exact temperature of 98-99 deg. F. Take a book or something to pass the time...wait 1 hour (start the time after the water is in). You might want to take the phone too...because it is going to ring at least once while you are in there...lol. When you are completed...have a small snack or a very light supper....this will normally "convince" anything remaining to "exit"...plus if you get no return, you will know that you are completely evacuated. I avoid high fiber and eat mainly protein. If you eat 5 pounds of fiber...you are going to get 4 pounds back... It's not abnormal to get a "slight" bit of output the next day...day 2 is clear for me and depending on what/how much I eat, so is day 3. It will take a little time to "train" your system to react predictably. If I have any trouble with low return...I will eat a good-sized handful of "wheat thin" crackers 7-8 hours before my next irrigation...again, something else may work for you.
Good luck and keep us posted on your progress.
Miss Scarlet
Thanks for your reply, Pam. I did have the first session with my stoma nurse. She told me to pull the cone in and out of the stoma when I was putting in the water, which meant most of it came straight back out again. My stoma worked, but only very little, and it was only one half of a liter, she said. I also asked her about the temperature gauge on the bag, and she said there wasn't one, but there is. To be fair, she has been a great support up until now, but I do not think she knows much about irrigation. If it was not for the video Mild Mannered Super Hero advised me to watch on YouTube, I would not have had a clue what to do. I would not have attempted it, I don't think. I learn by doing and someone showing rather than from a pamphlet about it.

Thanks, Mild Mannered Super Hero. I irrigate first thing in the morning as it suits me better. Thanks for all the tips. I will persevere.

Another thing which happened this morning: only one half of a liter went in and then the stoma would not take any more. I checked the flow hose and it was working, so I do not understand. I have been prone to blockages, so maybe that was it. I will see what happens tomorrow. Fingers crossed.

Maureen
Past Member

There should be a flow valve on the hose to slow or stop the water as required. I assume you have the bottom of the water bag hanging at shoulder height??
You may have to twist/tilt the cone one way or the other to help the flow....the cone is held lightly in place...if you push too hard you can possibly restrict the flow. Since the bowel is constantly moving...it may take some water and stop, lightly tilt/move the cone {but do not remove it}.    Gravity will win out if you just keep it in and gently    move it around to find that "sweet" spot where the water enters freely. You will feel just a little pressure as the water goes in...no worries...it's a sign that it's doing the job. It sometimes takes 5-6 minutes to get that 1.5 liters in. Good luck and keep us posted of your progress.
 
Words of Encouragement from Ostomy Advocates I Hollister
WAB
A colostomy is a surgically induced opening in the colon. Colostomy irrigation is a way to regulate stool through emptying the colon on schedule. Irrigation involves instilling water into the colon through the opening (stoma), which stimulates the bowel to empty. Repeated irrigation trains the bowel to empty with minimal stool between irrigations. Colostomy irrigation is a personal decision. The advantages of irrigation are freedom of movement, increased comfort, decreased gas, minimal odor, and less diarrhea and constipation.
Read more: How do I Flush a Stoma? | eHow.com http://www.ehow.com/how_6831511_do-flush-stoma_.html#ixzz0xbhac8Uv

I think the key word here is training the bowel.........also I remeber when I started it depends on the type of surgery you had....................I do not think all colostomy surgeries are the same and it depeneds on which part of the colon they removed............some stool is very liguid for some and for some normal......you should also check ..with surgeon......what type of stoma.....

I will give you a tip which I do..and well makes it much easier for me..I do my irrigation in the shower .........before I wash...all is needed is a bench .....and a bucket ....I find clean up is easier and..I seem to feel better and relaxed after having showered.............The irrigation bag I hang over the shower spout............Most people shower today..so is the ideal place to do it........clean up a breeze......and is comfortable to do it.......do not worry about wafers..as well they seem to stick more when wet........I have never had a problem..I use Hollister.....( new Image)

My guess is your bowels will become used to this procedure.....It took me 5 years before I started to do this..........and well it sets you free......no problem with going to restaurants...dinner parties..and travelling........I am a 11 year ostomate.......

You will find there are not many people doing irrigation..I asked my stoma supply outtlet and they told me I was the only one...for them ...imagine in a city of 3 million........so is probably new for your doctor and stoma nurse.............

Also I was told we should drink plenty of water................by my Doctor as well...we can get dehydrated more easily...........

Good luck to you......I guess you will be hearing from those who irrigate.......
WAB

My apologies, Miss Scarlet, but I forgot something...

A bit gross, but here goes... the usual scenario. When I want to irrigate, bear with me.

Ok, I have done my irrigation in the shower on the bench, and the stool is now in the bucket. (I dump it in the toilet after showering.) I feel I am finished irrigating... so I stand up and begin to shower, wash my hair, body, etc. Remember, I have been doing this for 6 years now.

Well, I have always found that by standing up, showering, and washing, I still have stool, and it will come out just by putting pressure and washing my stomach. It clears the intestines all the time, so that is why I say it is ideal to do it in the shower. Standing up and pressure clears all for me. You just need pressure on your stomach. Clean up is easy in the shower.

Sorry, it is a bit gross, but this is what works for me. I can go 3 days and have nothing in the bag as my system has become used to the procedure.

My apologies, but well, this is what I do. Maybe you have to try it once to see if you have the same experience.

Miss Scarlet
Mild-mannered superhero - Thanks for the advice. It happened again this morning - only half a litre went in. I will try moving the cone about and not holding it so tight. However, the difference this morning is great. Even though only half a litre went in, there was a lot of output and my bowel is now silent for a change (this is now 4 hours since my irrigation). For once, I feel my bowel has emptied. Great, so maybe half a litre will do the trick. However, I will try to put in a litre tomorrow and see what happens.

Wab - I think you are so right. I am training the bowel to perform a different way. I have had so many blockages, it is great to think that irrigation will solve my difficulties. Good advice about staying hydrated. Believe it or not, I do not have a shower. I live in an old house (120 years old) and the bathroom is a funny shape. If I wanted a shower, I would need to get rid of the bath, so really doing it in the shower isn't an option for me. Thanks for taking the trouble to tell me what you do. Maybe other people reading this post will try it in the shower. It sounds less messy.

Another question - I am going on holiday in 5 weeks' time to a caravan. I am worried there will be nowhere to hang my bag of water. What do other people do?

I am so glad I have this site. I do not know anybody else who irrigates, but I will be telling everyone how I am progressing at my next Stoma Support Group.

Cheers

Maureen
Pinky
Hi Maureen - When I traveled recently in SF, I used a little stick-up hook my daughter bought me. I was very surprised it held up the full water bag well, and at the end of the week, I got it off the fiberglass shower with no trouble. I have since bought some "S" hooks to hook up on the shower rod but haven't tried one yet.

After I wrote to you, I thought about how important the word "training" is. I'm glad others have commented on it.

I irrigate sitting in a chair facing the toilet. It takes about 25-40 minutes for me, depending on what's inside! I love fibrous foods because I went so long without them (7 years) - like berries, apples, veggies, etc., so I have to irrigate every day. I'm sure if I tried sticking to protein like Mild Mannered Superhero, I would lose weight (no carbs) and not have to irrigate every day!

I use the Coloplast kit because I like the little wheel that shows you how fast the water is flowing in and has the temperature gauge. It's also easy to fill. I just have to get Hollister sleeves to go with my New Image products. What I try to remember when (often) the water is troublesome first going in is that it is having to fight gravity until it gets into the transverse colon, and sometimes there is also a little stool sitting near the stoma opening that must be washed out.

There is an interesting video on the Cymed site showing Ben Moon, their spokesman, lying down when he irrigates. So I guess any comfortable position is acceptable!
WAB
Ahh Miss Scarlet

Ahh yes, I agree with Pinky. Get some S hooks at the hardware store. They can attach to the shower head, even if it's only a bath. It should have a shower head in hotels. I sat on the side of the bath with my bag hooked on the shower head.

I am very curious about your bathroom design (I'm a designer here), and there is always a solution to every problem. I do have a separate shower, but I also have a cast iron clawfoot bath that is freestanding. Maybe you have dormers? I am curious because they do have shower curtains that can attach to rods from the ceiling. I am very curious about the design, and maybe there is a solution for you. Let me know if maybe I can help.

A handyman or handywoman (lol) could fix it for you as well. Doing irrigation in an enclosed space that is easy to clean is a breeze, and you will not worry about accidents. You will be more relaxed, which I think is important to do the irrigation.

Check your hardware store for S rings and possible suction clips (heavy duty). Also, a portable tripod stand (like they use for cameras) would give you a place to hang your bag. Check it out.

So good luck.

WAB
Miss Scarlet

PAM - Thanks again. I use the Coloplast kit and like the wee wheel to control the flow. I will check out the local hardware store for stick-on hooks. Great idea.

WAB - Thanks for your advice. The hardware store here I come. I guess if I wanted a shower, it could be put into my bathroom. However, since I took unwell 3 years ago, every little thing to me is a potential stress situation. I would like a shower put in, but I feel panicky about the mess and what firm to use who won't rip me off.

Yet another question. I have tried out 2 different sleeves so far. I had the Coloplast one which came with the kit. Coloplast 1560 - a two-piece with a belt. As I have a urostomy as well, the belt went right over my urostomy and is not very comfortable for the hour I have to wear it. Now I am trying a Dansac 950-35 one-piece with adhesive. This has leaked underneath a few times. Has anyone a recommendation for a one-piece with adhesive that works? Or maybe I am not putting the sleeve on right.

Thanks
Maureen

Pinky

Maureen - you are one brave lady to be handling two ostomies at once!

I don't use an adhesive sleeve - it has a ring to snap onto the Hollister New Image ring. I don't really trust an adhesive bag for some reason.

Miss Scarlet

PAM - When you say you use a ring, does this mean with a belt? Do you have the Hollister model number? I really appreciate your help.
Thanks
Maureen

WAB
Hi again Miss Scarlet

I too have the new Image snap-on sleeve. It is easy to use. You do not need a belt.
I am sure your ostomy supply store can get one for you. And if you are having problems with the flange, get some hospital tape. It holds like crazy glue and comes off easily.

But here is a trick for supplies and to test things.

I called the company (many companies) and they sent me a kit free with all kinds of samples. Just say you want to try it. Maybe they will do it for free to keep you as a customer. This is for life.

Calling companies and speaking to their reps sometimes will get you samples to try. Give it a shot. Tell them what you think you need.

It is worth a try, as I am sure ostomy supplies are as expensive in your country as they are here.

Most companies will be happy to do so.

Good luck.
WAB
Miss Scarlet

Thanks, Wab. I will phone Hollister on Monday and see if they will send me some to try.
I appreciate your help.
Maureen

Miss Scarlet
I am persevering with this as I need it to work. As I explained, my bowel does not work unless I take a lot of Movicol, so I am hoping now I have stopped the Movicol, irrigation will work for me. Yesterday morning, I irrigated with 1 litre. There was not a lot of output. I went swimming and while I was there, my bowel was pushing and pushing to work but nothing came out. When I got back home, I was feeling really uncomfortable and I was due to meet some friends for lunch. So I irrigated again with 1 litre and this did the trick. Today, I decided to put in 1 1/2 litres instead of 1 litre to see if maybe that will empty my bowel. I did have some output but my stoma has continued to work all day.
Is this normal? Will my bowel eventually settle down? I can understand why people give up, but I am determined that this is the way forward for me.
I really appreciate hearing other people's experiences.
Thanks, Maureen
Miss Scarlet

I am still persevering. What works now is 1 litre of water then wait 20 minutes then another litre of water. It seems to do the trick.
Another question. Does anyone irrigate every 36 hours? I feel every day is too much and every 2 days too big a gap. I heard you are supposed to irrigate at the same time of day each time. So if I did it every 36 hours, it would be in the morning then the next time in the evening. Would this mess up training my bowel? Irrigation is definitely not for the faint-hearted.
Thanks for your help
Maureen

Past Member

I am wondering how things are progressing? Hope you have worked it out. MMsh

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