Discharge Instructions: Irrigating Your Colostomy

You have had a colostomy in the lower part of your large intestine (either the descending or sigmoid colon). Emptying your colon at scheduled times is called irrigating your colostomy. This may help control your bowel movements. It is done by putting water into the colon through the opening (stoma). Many people don't like this idea at first. But with practice, it can be part of your routine. The benefits of irrigation are:

• Freedom of movement

• More comfort

• Less gas

• Less odor

• Less diarrhea

• Less constipation

• Less skin irritation

A small stoma cap or plug may be used instead of a colostomy pouch between irrigations.

Being able to irrigate depends on where your colostomy is located. Irrigation should be done only if you have either a descending or sigmoid colostomy. Follow your healthcare provider's instructions. Here's what you need to know about irrigating your colostomy.

General guidelines

Before starting an irrigation program, get specific instructions from your healthcare provider or from an ostomy nurse.

Irrigate your colostomy the same time every day. This will take 45 minutes to 1 hour. Don't do it if you have diarrhea. Or if you are not feeling well. Resume irrigation when your normal bowel function returns. Drink 6 to 8 glasses of water every day, unless directed otherwise.

Gather your equipment

You can buy a special irrigation kit. Most kits have:

• Irrigation bag

• Irrigation sleeve

• Irrigation belt (used for a two-piece appliance)

• Water-soluble lubricant 

Preparing the bag

Tips to prepare the bag include: 

• Make sure the gauge on the irrigation bag tubing is turned off.

• Fill the irrigation bag with a quart of tap water. Then hang the bag near the toilet in the bathroom. The bag should be at head level as you sit on a chair.

• Make sure the water you use isn’t too cold or too warm. Lukewarm or slightly cool water works best for most people.

• Sit on a chair or stool next to the toilet.

Setting up the sleeve

Tips to set up the sleeve include: 

• Remove your colostomy pouch and attach the irrigation sleeve.

• Center the stoma in the ring of the irrigation sleeve. Fasten the belt if you are using a kit with a belt.

• Place the other end of the sleeve in the toilet. It should be at or just below the water level to prevent splashing of the drainage. 

• Remove the air from the tubing by running a little water through the opening in the top of the sleeve.

Inserting the cone and draining the stoma

Tips to insert the cone and drain the stoma include: 

• Grease the cone tip.

• Put the cone tip gently into the stoma at the angle advised by your healthcare provider or ostomy nurse.

• Open the gauge on the bag. Let the water run into the colon.

• Stop or slow the water if you become uncomfortable.

• Press firmly on the cone to keep it in the stoma.

• Once the water in the irrigation bag has emptied into your colon, remove the cone tip from the stoma. Close the top of the irrigation sleeve.

• Sit quietly with the sleeve in the toilet for 15 to 20 minutes. Do this until the stool and water have stopped draining.

• Rinse the sleeve with water. Leave the sleeve in place and clamp it. You may now leave the bathroom. Most of the water and stool will go back into the sleeve in the next 20 to 30 minutes. Relax. Read or do other quiet activities while you wait for stool to return.

Cleaning up

Tips to clean up include the following: 

• When your stoma has stopped draining, return to the bathroom. Rinse and remove the sleeve.

• Wash the skin around your stoma. Pat it dry and apply your stoma appliance.

• Clean your sleeve and bag for future use.

Follow-up

Make a follow-up appointment as directed by your healthcare team. 

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following:

• Too much bleeding from your stoma or blood in your stool. Depending on the amount of bleeding, your provider may tell you to get medical care right away or call 911.

• A stoma that separates from the skin or looks like it's getting longer

• Skin around the stoma is bulging, red, or warm to the touch

• Change in the color of your stoma

• No gas or stool for more than 36 hours

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• Shaking chills

• Upset stomach or vomiting

• More pain