Colostomy Care & Irrigation

Introduction
A colostomy is a surgical procedure that involves
connecting a part of the colon onto the anterior
abdominal wall, leaving the patient with an
opening on the abdomen called a stoma. In a
colostomy, the stoma is formed from the end of
the large intestine, which is drawn out through the
incision and sutured to the skin. After a
colostomy, feces leave the patient's body through
the abdomen. A colostomy may be permanent or
temporary, depending on the reasons for its use.
Colostomy irrigation is the introduction and
drainage of volume of fluid to and from the
colostomy.
Human Digestive System
Purpose
To stimulate peristalsis.
To evaluate feces, gas or mucus from the
colon.
To cleanse the lower gastrointestinal tract
in colostomy irrigation.
To establish a regular pattern of
evacuation.
To control odor from the colostomy.
Equipment and Supplies
Irrigating can or enema bag
Irrigation solution: 500-1000 ml Normal Saline
Solution
Connecting tube with clamp
Rubber catheter fr. 22-24
Irrigating sleeve/sheath (colostomy bag)
Water soluble lubricant
Tissue wipes
Emesis basin
Bedpan
Receptacle for soiled dressing and disposable
pouch
Procedure
Suggested Actions
1. Apply irrigating sleeve or sheath to 
stoma. Place end over the bedpan,
commode or toilet bowl.
2. Expel air from the tubing and
catheter. Insert well the lubricated
gloved finger.
3. Gently insert lubricated catheter
into stoma for 3-4 inches and hold
firmly in place.
4. If catheter does not advance easily, 
allow solution to flow while
inserting the catheter. Never force
the catheter.
Rationale
To prevent spillage of feces and
control odor.
 To prevent introduction of air into
the colon which could cause
abdominal cramps. To check for
stoma structures and to dilate the
stoma.
 To prevent perforation of the
colon.
To help relax the colon and
facilitate insertion of catheter.
Procedure
Suggested Actions Rationale
5. Introduce solution slowly. If  To prevent painful cramps.
patient experiences cramps, stop
flow of solution for few minutes
before progressing. Allow fluid to
flow for 5-10 minutes.
6. Initial volume of solution is 500  To have effective result of the
ml, maybe increase up to 1000 ml procedure.
with subsequent irrigations
7. Hold the catheter in place, after
instillation of solutions, and then
remove slowly and gently.
8. Allow drainage of solution for 10-  To expel water, feces and flatus
15 minutes. adequately.
Procedure
Suggested Actions Rationale
9. Clean the skin around the stoma,  To protect the skin from irritation.
dry the area.

10. Change colostomy bag. Encourage  To further stimulate peristalsis and

ambulation if possible. complete irrigation return.

11. Discard contaminated articles

aseptically.

12. Record the following:

 Time the procedure was done.
 Character and amount of fecal
drainage.
 Reaction of patient to the
procedure
Special Consideration
 Provide privacy and psychosocial support and
comfort.
 Utilize the treatment time of irrigating colostomy as
the learning time for the patient to manage his
colostomy independently.
 Warm the solution to body temperature to enhance
peristalsis and prevent abdominal cramps.
 Select a convenient time for the procedure, the
clients usual daily bowel movement.
 Hang irrigating can 18-20 inches above the stoma
(shoulder level when sitting).
Special Consideration
Lubricate the catheter before insertion to
prevent trauma.
Place in upright position – may sit on
commode or toilet bowl. If unable to sit
upright, may be placed in lateral position
(depends on location of colostomy).
The client should never use more than
1000 ml, irrigate the colostomy more than
once a day, or irrigate the colostomy if
diarrhea is present.
Special Consideration
Minimize flatus by using odor-proof
pouches and pouches with charcoal filter
and limit eating gas forming foods.
Teach the client the proper application of
pouch to the stoma. A healthy stoma is
red and slightly raised. The skin around
the stoma should be clear, without
evidence of irritation.
The pouch should be changed every 4-5
days or when leakage occurs.
Thank You & Good Day!