Discharge Instructions: Irrigating Your Colostomy

Irrigating your colostomy is a way to help regulate your bowel movements. Many people are put off by the procedure at first, but with practice it can become part of your routine. Advantages of irrigation are freedom of movement, more comfort, less gas, less odor, less diarrhea, less constipation, and less skin irritation. A small stoma cap or plug may be used rather than a colostomy pouch between irrigations. Before starting an irrigation program, get specific instructions from an enterostomal or wound-ostomy-continence healthcare provider. Here's what you need to know about irrigating your colostomy. 

General guidelines

Irrigate your colostomy the same time every day. The process takes 45 minutes to an hour to complete. Don't irrigate if you have diarrhea or 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 contain:

• Irrigation bag

• Irrigation sleeve

• Irrigation belt (used for a 2-piece appliance)

• Water-soluble lubricant 

Preparing the bag

Tips to prepare the bag include the following: 

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

• Fill the irrigation bag with a quart of tap water and 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 patients.

• Sit on a chair or stool beside the toilet.

Setting up the sleeve

Tips to set up the sleeve include the following: 

• 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 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: 

• Lubricate the cone tip.

• Insert the cone tip gently into the stoma at the angle recommended by your healthcare provider or enterostomal therapist.

• Open the gauge on the bag and 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 and close the top of the irrigation sleeve.

• Sit quietly with the sleeve in the toilet for 15 to 20 minutes 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 return back into the sleeve in the next 20 to 30 minutes. Relax. Read or do other quiet activities while you wait for stool 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.