Colostomy care

I have a good friend/partner, diagnosed 4 years ago with anal cancer. He underwent chemo and radiation at that time. This left his rectum and pereneal area rigid, with a lot of scar tissue. Six months ago his doctor discovered a return of cancer cells in the area around his anus. Surgery was recommended, with the removal of his anus and rectum. He is recovering very well, at this point. He has a new ostomy, left and below his navel. The surgery was performed robotically with very few incisions in his abdomen. The wound, where his anus was is healing slowly, due to prior scaring and limited blood flow, to the pereneal area, but is progressing to heal with new tissue growth.

He is adjusting fairly well to the ostomy, and his diet hasen't changed dramatically. Needless to say, my medfet/curiousity has increased over the past 6 months, since I have part of his home care, along with his home nursing staff. My continual interest in enemas (which he does not share!) leaves me wondering whether ostomy patients ever irrigate their bowel through their stoma? It feels pretty strange having this query, but I suppose this might be a fairlly good audience to ask?

I'm not a medical professional, but I do play one in the bedroom! I think this is not an appropriate format for this discussion. While I applaud your curiosity, if your friend's doctor felt the bowel needed to be irrigated, he would give instructions to do so. From an anatomical point of view I can see some problems with flushing what amounts to a closed system.

Colostomy irrigation is an important part of a patient's self-care. One of the reasons is that it empties the colon for a period afterwards allowing the patient to be in a social setting without the embarrassment of the colostomy bag draining. Patients will normally be taught the techniques required by their Ostomy Care Nurse or Therapist, and if they do not know they should ask their care provider.

I stand corrected! However, I still think this is not the place for this discussion.

DrJ58 is correct. Colostomy patients do irrigate their colon through the ostomy. It makes their times away from the house much easier for them.

I don't believe there is a problem discussing this because we do discuss other conditions as ED, constipation, UTI infections, colonoscopy procedures and experiences and GU problems.

As long as it is clear that we are not specifically dispensing medical information as the ultimate authority and people are aware we do not have medical licenses or the ability to examine patients, and people know they should discuss their condition with their physician, then we can have these discussions.

I am not sure why this would not be an appropriate place for discussion, perhaps it is part of the stigma surrounding Colostomies. A person who has a colostomy is not much different than someone with a normally functioning colon, other than they have a second "anus" higher up which serves the purpose of elimination. The only functional difference for most patients is that rather than having stool collect in the rectum until they are able to use a toilet, colostomy patients collect the waste in a bag attached to their abdomen as it reaches the stoma. For diagnostic purposes the stoma is no different than the anus in that the remaining colon is easily examined by endoscopy or barium enema through the colostomy.

A colostomy irrigation is really no different than an enema, and we have an entire board devoted to that subject. Usually colostomy patients are instructed in the technique of self-irrigation as part of their post-operative rehabilitation. There is little difference in the equipment other than a different type of nozzle which mates with the stoma, however one must keep in mind that colostomy patients have a shorter colon which has less capacity than a normal colon. Most patients will experience the same abdominal sensations they would if a large volume enema was being administered rectally. Otherwise any medical and health benefits derived from enemas and colonics will benefit colostomy patients equally.

Over-ruled, I give.

Thank you!

SOME colostomy patients use regular irrigation as part of their care. It was stressed as a nearly ubiquitous part of colostomy management in the past, but has become less common in recent years.

There are also different types of colostomy. A sigmoid or descending colostomy can respond well to irrigation. Irrigation is less appropriate for a transverse or ascending colostomy; there is simply less colon left to hold the water and the patient's stool is usually looser.

As in many topics; ask the man who owns one.