Colostomy Irrigation

What is a colostomy?

A colostomy is a surgical procedure that connects part of the large intestine (colon) to a surgical opening in the abdominal wall (stoma). As part of the digestive system, the large intestine helps move poop (stool) out of the body.

When you have a colostomy, stool exits the body through the stoma instead of the rectum. A bag that attaches to the stoma (skin) collects the stool. You empty this bag several times during the day.

Some people need colostomies for a short time while the colon or rectum heals. A surgeon then reattaches the ends of the intestine and closes the stoma. Other people need permanent colostomies.

A colostomy is different than an ileostomy, which also moves stool out of the body. It connects the small intestine (ileum) to a surgical opening in the abdominal wall.

What is colostomy irrigation?

Colostomy irrigation is a way to remove stool without wearing a colostomy bag all the time. You use the stoma to wash out the colon with water (like an enema). You perform this procedure at the same time every day, or every other day, depending on your needs.

Who needs colostomy irrigation?

People with certain digestive tract disorders that affect the large intestine (colon and rectum) may need a colostomy. While there are several conditions that need this, the more common ones include:

• Anal cancer or colorectal (colon) cancer.
• Cervical cancer or vaginal cancer.
• Diverticulitis.
• Fecal incontinence.
• Hirschsprung disease.
• Inflammatory bowel disease (IBD), including Crohn’s disease.
• Intestinal injury or trauma.
• Large bowel (intestinal) obstruction.

Who is a candidate for colostomy irrigation?

Irrigation works best when stool is firmer. For this reason, irrigation is only an option if you have one of these colostomy types:

• Descending: The descending colon, which runs down the left side of the abdomen, connects to the stoma. Solid stool starts to form in this part of the colon.
• Sigmoid: A sigmoid colostomy connects the last part of the bowel (sigmoid colon) to the stoma. The sigmoid colon moves solid waste into the rectum.

What colostomy irrigation supplies do you need?

You need special medical supplies to perform colostomy irrigations. You can get these supplies from your healthcare provider, pharmacy or medical supply store. You need:

• Adjustable belt.
• Closure clips.
• Irrigation sleeve and system (container and tubes).
• One-half to 1 quart of warm water (500 to 1,000 cubic centimeters).
• Water-based lubricant.

How is colostomy irrigation performed?

Your healthcare provider will show you how to perform colostomy irrigation. Here’s what you should know:

• The process can take up to one hour. It gets easier with practice and time.
• It’s best to perform irrigation at the same time each day.
• You may want to try irrigating at the time of day you typically had a bowel movement (before getting the colostomy).
• Irrigation may be easier after a meal or hot drink.
• Abdominal pain or nausea may occur during irrigation, and may mean that water flow is too fast or the water is too cold.
• In six to eight weeks, your bowels will typically adjust, and bowel movements will become regular.
• A cap covers the stoma between irrigations.

What are the potential risks or complications of colostomy irrigation?

You may develop skin irritation around the site of the stoma. You should call your healthcare provider if you notice signs of infection, such as burning, itching or waterish discharge. It’s normal to have a small amount of blood at the stoma.

A colostomy may make you more prone to constipation or diarrhea. It’s important to get enough fiber in your diet and drink plenty of water to prevent these problems. Some people experience a small amount of stool leakage between irrigations.

Having a colostomy may affect how you feel about yourself and your body image. It’s not always easy to control things like passing gas and odors. Talk to your healthcare provider if you start to feel anxious or depressed.

How effective is colostomy irrigation?

If not having a bag is important to you, colostomy irrigation can be an effective way to remove stool from the body.

When should I call my healthcare provider?

You should call your provider if you experience:

• Change in stoma size or appearance.
• Chronic skin irritation or signs of skin infection.
• Extreme nausea and vomiting.
• Significant decrease in gas or stool (stoma output).
• Severe stomach cramps that last for more than a few hours.
• Unusual odor, severe bleeding or watery discharge from the stoma.

A note from Cleveland Clinic

Adjusting to life with a colostomy can be challenging. For some people, a colostomy is temporary. Others will always need one. Your body just needs to do this normal process in a slightly different way. Over time and with practice, irrigation becomes easier. Your healthcare provider can help you adjust to this new way of using the bathroom. Whether you choose to irrigate or wear a pouch, a colostomy shouldn’t keep you from doing the things you love.