Colostomy Irrigation

Overview

What is colostomy irrigation?

A colostomy is an opening in the colon that is brought to the outside of the abdomen so that waste empties through that hole into a bag, instead of going out the rectum and anus. Colostomy irrigation is a way to regulate bowel movements by flushing and emptying the colon at a scheduled time. Usually, a bag won't need to be worn between irrigations.

The process involves instilling water into the colon through the colostomy, or stoma, which stimulates the colon to empty. By repeating this process regularly – once a day or once every second day – the colon can be trained to empty with minimal spillage of stool in between irrigations. Colostomy irrigation also can help avoid constipation.

Colostomy irrigation is a personal decision. If you are a candidate, your doctor or a nurse who is specially trained to help people with colostomies will discuss this option with you.What is a colostomy?

The colon, rectum and anus are the last sections of the body's digestive system. Although they are an important part of the system, they have little to do with digesting food or absorbing nutrients. In fact, the large intestine can be thought of as the body's trash compactor. As "leftover" liquid flows through the colon, it becomes solid waste (feces). The waste material passes through the colon, then moves onward to the rectum. From there, it is eliminated from the body through the anus.

When the colon, rectum or anus is unable to function normally because of disease or injury, or when a part of this bowel is cut out and reconnected and needs to heal, the body must have another way to eliminate the waste. By bringing the large intestine through a hole in the abdominal wall, gas and feces empty into a bag worn on the outside of the abdomen. This is called a colostomy, or stoma, and it provides a new path for waste material to leave the body. Colostomies can be permanent or temporary.

What is colostomy irrigation?

A colostomy is an opening in the colon that is brought to the outside of the abdomen so that waste empties through that hole into a bag, instead of going out the rectum and anus.

Colostomy irrigation is a way to regulate bowel movements by flushing and emptying the colon at a scheduled time. The process involves instilling water into the colon through the colostomy, or stoma, which stimulates the colon to empty. By repeating this process regularly – once a day or once every second day – the colon can be trained to empty with minimal spillage of stool in between irrigations. Colostomy irrigation also can help avoid constipation.

Colostomy irrigation is a personal decision. If you are a candidate, your doctor or a nurse who is specially trained to help people with colostomies will discuss this option with you.

Why is a colostomy created?

There are many reasons why a colostomy becomes necessary. Some of the conditions that may require a colostomy include:

  • Colon, rectal, or anal cancer
  • Traumatic injury
  • Intestinal blockage
  • Diverticulitis (an inflammation or infection of small sacs or outpouchings, called diverticula, of the inner lining of the intestine)
  • Crohn's disease (a type of inflammatory bowel disease)
  • Incontinence or constipation

Who is a candidate for colostomy irrigation?

Patients with permanent colostomies made in the descending or sigmoid portion of the colon and who had regular bowel function before having a colostomy are good candidates for irrigation. This is because their stools tend to be more formed. Colostomy irrigation may not be a successful method of regulation for persons with a history of irritable bowel or irregular bowel action. Irrigation may be cumbersome for persons with certain physical limitations, such as arthritis, visual impairment, paralysis, or palsy. Some persons find the procedure too time consuming or unpleasant. In these cases, wearing a pouch or bag and emptying that several times a day is a better method of colostomy care.

Procedure Details

How is a colostomy created?

A colostomy requires a surgical procedure performed under general anesthesia. During the surgery, the surgeon creates a hole in the abdominal wall. A part of the healthy colon is brought through this opening in the abdomen and stitched to the skin. Unlike the anus, the opening of the colostomy has no sphincter muscle, so you cannot control the exit of waste. A pouch or stoma bag is worn on the abdomen and collects the waste. The pouch is emptied several times throughout the day, and the pouch is replaced a couple of times a week.

When is irrigation done?

Colostomy irrigation may be done once a day or once every other day depending on your preference and ability to regulate your bowel movements. It generally takes about six to eight weeks for the bowel to become regulated with irrigation. It is important to establish a routine and irrigate at the same time each day.

Risks / Benefits

What are the complications of a colostomy?

In some cases, skin irritation can result from stool that leaks under the pouch. A hernia can develop around a colostomy. The bowel may become narrow or it may prolapse, which means it gets longer. Proper fitting of an ostomy pouch can help prevent skin irritation. The wound, ostomy, continence nurse, also called a stoma nurse, can help choose an appropriate pouch and suggest ways to care for your skin.

Recovery and Outlook

Is a colostomy permanent?

A colostomy can be permanent or temporary, depending on the condition being treated and the surgery performed. A temporary colostomy may be done to allow part of the intestine to rest and heal. Only 10% of patients with rectal cancer and less than 1% with colon cancer will need a permanent colostomy.

How will a colostomy change my life?

If you do need to have a colostomy, there will be some changes in your lifestyle, but generally, you can do all the same activities as someone who doesn’t have a colostomy.

Because colostomy irrigation uses an enema through the stoma to clear the colon, a pouch may not be necessary.

While in the hospital after your surgery, you'll be taught how to take care of the colostomy. You will learn how to empty and change the pouch. A nurse can come to your home to reinforce what you’ve learned in the hospital. Medical supply stores and some drug stores carry supplies to help you care for your colostomy. You will need to check with your insurance carrier to determine if it covers colostomy supplies.

Some patients find the advice and support of other colostomy patients helpful. There are ostomy support groups available to provide additional information and emotional support.

With a colostomy, you may have to regulate your diet to avoid constipation or diarrhea.

Here are some additional tips to help you adjust to your colostomy:

  • Monitor your medications. Some medicines can cause constipation or diarrhea.
  • Eat a well-balanced diet. Avoid foods that cause excessive gas. A dietitian can help you choose a balanced diet that will not interfere with your colostomy.
  • Live your life. Modern colostomy supplies are odor-proof, designed to lie flat, and are not noticeable under clothing. Most colostomy patients are able to return to work and to many of the activities – including physical intimacy with another person – they enjoyed before surgery.

Be sure to talk with your doctor or nurse about resuming your normal activities and about any concerns you have about living with your colostomy.

Last reviewed by a Cleveland Clinic medical professional on 11/07/2016.

References

  • United Ostomy Associations of America, Inc. Colostomy Fact Sheet Accessed 6/10/2020.
  • Colostomy UK. Irrigation. Accessed 6/10/2020.
  • American Cancer Society. Caring for a Colostomy. Accessed 6/10/2020.
  • Kent DJ, Arnold Long M, Bauer C. Revisiting colostomy irrigation: a viable option for persons with permanent descending and sigmoid colostomies. J Wound Ostomy Continence Nurs. 2015;42(2):162‐164.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy