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How to Do a Colostomy Irrigation: A Step-by-Step Guide

colostomy irrigation

Marc Kaplan |

After having a part of your color or rectum removed, you're going to need a colostomy, or stoma. This opening connects your colon to the surface of the abdomen, allowing you to flush bowel and waste from your body.

While it doesn't exactly sound glamorous, more people live with a colostomy bag than you'd think.

In fact, it's estimated there are between 450,000 and 800,000 ostomy patients in the country.

It's important to know how to manage colostomy irrigation on your own. With this step-by-step guide, you can train your colon to empty, avoid constipation, and maintain your health. 

Here's everything you need to know about colostomy care and stoma irrigation. 

An Intro to Colostomy Irrigation

Colostomy irrigation is an effective way to help you empty your colon on a schedule. By pouring water through the stoma and into your colon, you can flush your colon out. 

Setting a schedule can help you regulate your bowel movements. By emptying your colon at the same time each day, you can also avoid constipation and leaks. Colostomy irrigation will help you remove waste and gas on a schedule that's convenient for your daily life. 

However, colostomy irrigation isn't ideal for everyone. 

Consider performing colostomy irrigation if:

  • You're an ostomy patient with a permanent colostomy
  • Your stoma opening is in the sigmoid or descending portion of the colon

Patients who meet this criterion are ideal for colostomy irrigation because their stools are more formed. You're not suited for a colostomy bag if you have:

  • Irritable bowel syndrome
  • Stomal issues
  • Stomas in the traverse or ascending colon

Make sure to speak with your physician to determine if stoma irrigation is right for you.  

When is the Best Time?

According to a survey, 30% of people complete a colostomy irrigation every one to three days.

However, it's more hygienic to maintain a daily schedule. Daily colostomy irrigation will help you avoid constipation, maintain regular bowel movements, and avoid leakage.

There's no fixed interval, though. You might decide on once every day. Your schedule depends on personal preference as well as your ability to regulate bowel movements.

Regardless of how often you irrigate, make sure it's the same time each day.

It can take between six to eight weeks for your bowl to become regulated with colostomy irrigation.

It's usually best to schedule your stoma irrigation one hour after eating. Try to irrigate at the same time every day. To keep to a schedule, try to eat at the same time each day as well. 

It also helps to schedule your irrigation when you're most relaxed. Look for a time when you can avoid interruptions. Otherwise, you might break your routine, which can make regular irrigation more difficult in the future. 

Required Supplies

Before your first irrigation, make sure you have the proper supplies. Your ostomy irrigation supplies should include:

  • Paper towel or a washcloth
  • An irrigation kit (including an irrigation bag, tubing, and cone tip)
  • An irrigation sleeve
  • Water-based lubricant
  • A colostomy punch
  • 500 mL of lukewarm water

Once you have the right supplies in hand, you're ready to start. 

The Process

The process for colostomy care often takes up to an hour. 

Prep

First, choose an ostomy pouch that fits your ostomy. You'll need to connect the tubing to the close clamp and the irrigation bag.

Next, fill the irrigation bag with the lukewarm water, stopping at the 1000 CC marker. Remember, the water should feel lukewarm; not too hot or too cold. You can use safe drinking water for irrigation if needed. 

How much water you use will affect the speed of water as it flows into your stoma.

Using 1000 mL of water will take about 10 minutes. Make a note if the water stops flowing. This means you'll need to change the cone's position. 

Next, open the clamp and allow water to run through the tube. This will remove air from the irrigation tubing. Make sure there's no air left before closing the clamp.

Otherwise, you could experience swelling and cramping. 

Hang the irrigation bag so the bottom is at shoulder height when you sit down. Some people attach a hook to their shower curtain rod for convenience. 

For an easy, cleaner irrigation process, sit on the toilet or in a chair facing the toilet.

If you're sitting on a chair, place a towel across your lap to support the sleeve.

Then, attach the sleeve to the mounting ring by using the locking ring. 

Colostomy Care Procedure

Remove your used colostomy pouch and clean away any stool using the washcloth.

Next, attach the irrigation sleeve and the ring around the stoma site. Allow the end of the sleeve to skim the top of the toilet water to prevent splashing. Lubricate the cone before inserting about half of it into the stoma.

Don't rush this step or apply force.

Once the cone is in place, open the clamp and slowly allow water to flow into the colon. Stop if you experience severe cramping. 

Pull the sleeve over the stoma and remove the cone. You'll have a large outflow of water and stool at first. Once most of the fluid returns, rinse the sleeve.

After about 15 minutes, fold the top of the irrigation sleeve, using the clamps to hold it closed. Once most of the fluid returns, you can resume normal activity. The irrigation will require about 30 to 45 minutes.

Once it's finished, return to the toilet to unclamp and empty the irrigation. Rinse it out. Then, clean the stoma and skin around it before applying your ostomy pouch the usual way.

After cleaning your irrigation sleeve and mounting ring, you can get back to your day!

The Royal Flush: Start Using Your Colostomy Irrigation Guide

By following this step-by-step colostomy irrigation guide, you can maintain your health and regular bowel movements. Make sure you have all the supplies you need before you start, and don't rush! Instead, take your time and keep your comfort in mind. 

Explore our medical supplies today for more ways to maintain your ostomy care.