This information explains how to irrigate your sigmoid or descending colostomy.
When you irrigate your colostomy, you’re putting water through your stoma into your large bowel (colon). This allows you to empty your bowel. Irrigating your colostomy at the same time every day will help train your bowel to function on a regular schedule. This may allow you to stay free of drainage for 24 to 48 hours.
You may want to irrigate within an hour after having a meal or hot drink. The irrigation will take up to 1 hour. It’s important that you never rush the irrigation.
Before you begin irrigating on your own, make an appointment with a Wound, Ostomy, and Continence (WOC) nurse. Your WOC nurse will give you instructions and will show you how to irrigate during this appointment.
When to Irrigate Your Colostomy
It’s important to irrigate your colostomy close to the same time every day. Your colon will get used to emptying at this time and you’ll be less likely to have bowel movements between irrigations.
You may want to irrigate within 1 hour after having a meal or hot drink. The irrigation will take 1 to 1.5 hours. It’s important that you never rush the irrigation.
Don’t irrigate your colostomy if:
- You have diarrhea (loose or watery stool).
- Your stoma is prolapsed.
- You notice a bulge (hernia) around your stoma. If you notice a bulge or hernia, call your doctor and meet with a WOC nurse.
Check with your doctor before irrigating while you’re getting chemotherapy or radiation therapy. Irrigation isn’t recommended during these treatments.
Instructions for Irrigating Your Colostomy
Before you start, gather your supplies. You’ll need:
- An irrigation bag, tubing, and cone tip
- A wall hook or coat hanger
- An irrigation sleeve and clamp
- Water-based lubricant
- A colostomy pouch or stoma cap
- Mild soap such as Dove® or Ivory®)
- Paper towels or a clean washcloth
- Water
Set up your supplies in a bathroom.
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Clamp the tubing on the irrigation bag and fill the bag with warm water. Never use hot or cold water.
- The irrigation bag has markings to help measure the amount of water. Fill the bag with a little more water than you need.
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Use the following amount of water:
- On the first day, use 250 milliliters (mL) of water.
- On the second day, use 500 mL of water.
- On the third day, use 750 mL of water.
- Starting on the fourth day, if you’re having a large bowel movement when irrigating using 750 mL of water and you don’t have any bowel movements between irrigations, keep using 750 mL of water. If you’re having bowel movements between irrigations, use 1,000 mL of water. Don’t use more than 1,000 mL of water.
- Loosen the clamp to let some of the water drain through the tubing of the irrigation bag. This will push out any air. Once only water flows out of the cone tip, re-clamp the tubing.
- . Hang the irrigation bag on a wall hook or coat hanger so the bottom of the bag is at your shoulder level. This means the bag should be about 18 inches (1.5 feet) above your stoma. Sit on the toilet or in a chair next to the toilet
- Unsnap and remove the colostomy bag from your stoma or remove your pouching system. Snap on the irrigation sleeve or apply a disposable irrigation sleeve. Place the end of the irrigation sleeve in the toilet.
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Cover the cone tip with water-based lubricant. Put the lubricated cone tip through the top open end of the irrigation sleeve and gently put it into your stoma.
- Angle the cone tip so it follows the natural direction of your colon.
- Never force the cone tip into your stoma.
- Never put the cone tip into your stoma beyond its widest point.
- Hold the cone tip in place for 1 to 2 minutes before starting the irrigation. Take a slow, deep breath. This will relax your abdominal (belly) muscles.
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Release the clamp on the irrigation bag tubing little by little. This will let the water flow slowly into your colostomy. It’s normal to feel bloated as the water flows into your stoma.
- If water back flows around the cone tip or doesn’t flow into your stoma, gently change the angle or position of the cone tip. Keep adjusting it until water flows and there’s no backflow of water.
- If adjusting the cone tip doesn’t help, there may be stool trying to empty from your stoma. Clamp the tubing and take the cone tip out of your stoma to let the stool flow from your colostomy. Once the stool has passed from your colostomy, put the cone tip back into your stoma and try to irrigate again.
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If you have cramping while you’re irrigating:
- Stop the flow of the water, take some slow deep breaths, and gently rub your abdomen. This will help your muscles relax.
- Check the height of the irrigation bag. If it’s too high, the increased pressure can cause cramping. If this is the case, adjust its height.
- If the water flows into your colon too fast, it can cause cramping. Adjust the clamp to slow down the flow.
- When the irrigation bag is empty, close the clamp on the tubing and remove the cone tip from your stoma. Set the irrigation bag, tubing, and cone tip aside. Close the top of the irrigation sleeve.
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Returns (water and stool) may start coming out of your stoma within 5 to 10 minutes. Sometimes, they may start sooner. The amount of returns may be different each time you irrigate. You may have returns more than once during the irrigation.
- Stay in the bathroom with the end of the irrigation sleeve in the toilet until the first return.
- After the first return, it’s OK to leave the bathroom. If you choose to leave, pull the irrigation sleeve out of the toilet and close the bottom with the clamp provided. Clean and dry the bottom of the irrigation sleeve with a moistened wipe or paper towel before leaving the bathroom. Don’t flush the wipe or paper towel down the toilet.
- You may want to use the next 30 to 45 minutes to continue with your usual routine. It’s safe to leave the bathroom, but you should stay close in case you have more returns.
- The irrigation may take over 1 hour. Never rush the irrigation.
- After the final return (about an hour after you started the irrigation), empty the contents into the toilet. Take the irrigation sleeve off your stoma and wipe any extra stool off your stoma. Put your colostomy pouch or pouching system back on. Flush the toilet and clean your hands with soap and water.
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Clean your equipment.
- Rinse it with water to remove any extra stool.
- If you used a disposable irrigation sleeve, throw it away.
- If you used a reusable irrigation sleeve, use a paper towel or washcloth to wash it with mild soap and lukewarm water. Don’t use hot water because it may damage the plastic. Dry the inside and outside of the irrigation sleeve with a paper towel or washcloth, or leave it out to dry.
If you have any questions or concerns about irrigating your colostomy, contact your healthcare provider.