Ateneo de Zamboanga University
College of Nursing
NCM 112j RLE
Name: ______________________ Date: _________
Year/Section: ________________
Colostomy Irrigation
Colostomy Irrigation : is a way to regulate bowel movements by emptying the colon at a scheduled time.
The process involves infusing water into the colon through the stoma. This stimulates the colon to empty.
By repeating this process regularly — once a day or once every second day — the colon can be trained
to empty with no spillage of waste in between irrigation.
• Irrigation should be done at the same time each day in order to establish regularity of bowel
evacuation.
Purpose:
To empty and cleanses the colon and rectum
To stimulate peristalsis and help develop regular bowel movement.
To relieve flatulence.
PROCEDURE 1 2 3 4 5
1 Assessment:
.Review the procedure with the patient, if necessary
Observe the stoma for complications
2 Assemble the necessary equipment (Equipment can be kept at the
patient’s bedside or in the bathroom.)
Irrigation kit (irrigation bag with clamp and tubing,
cone-tip irrigation catheter, irrigation drain pouch).
Water soluble lubricant.
IV pole (or other suspending hook).
Soap and water.
Washcloth and towel.
Ostomy appliance
Waste receptacle.
Prescribed irrigating solution, usually 500-1000cc
warm (100º–105ºF) tap water.
3 Nursing responsibilities before the procedure
1. Verify patient’s identity. Introduce self.
2. Explain procedure to the patient. Gather Equipment.
3. Practice Hand hygiene. Don gloves.
4. Provide for privacy
.
5. If the patient is ambulatory, have the patient sit on the toilet
or on a chair facing the toilet. If the patient is bedridden,
elevate the HOBº 45-90ºand position Chux around the
patient.
4 Nursing Responsibilities During the Procedure
6. Fill the irrigation bag with the prescribed solution and hang it
on the IV pole or hook.
(a.) The bottom of the bag should be at the patient’s shoulder
level when he is seated to prevent fluid from entering the
bowel too rapidly.
(b.) The bottom of the bag should be placed 18 to 20 inches
above the stoma when the patient is in bed.
7. Open the clamp on the irrigation tubing and allow the solution
to fill the tubing. Reclamp. (This prevents the administration
of air into the intestines.)
8. Prepare to begin the colostomy irrigation.
a. Remove the ostomy pouch, if applicable, and place the
irrigation drain pouch over the stoma. (Attach stoma belt if
required.)
b. Place the bottom, open end of the irrigation drain pouch in
the toilet (or bedpan) to facilitate drainage by gravity.
c. Connect the cone-tip catheter to the tubing and flush with
solution.
9. Lubricate the cone with the water-soluble lubricant to avoid
irritating the mucous membranes.
10. Gently insert the cone into the stoma so that the stoma is
occluded. Unclamp the irrigating tubing and allow the water
to flow in slowly
a. Allow water to enter the colon over a period of 10 to 15
minutes.
b. If cramping occurs, slow down the flow rate and ask patient
to deep breathe until cramps subside. Cramping during
irrigation may indicate that:
(b.1) The bowel is ready to empty.
(b.2) The water is too cold.
(b.3) The flow is too fast.
(b.4) The tube contains air.
11. Clamp the catheter and remove from the stoma. Fold down
the top opening of the irrigation drain pouch and secure it in
the closed position.
12. Have the colostomy patient sit on or near the toilet for about
15 to 20 minutes so the initial colostomy returns can drain
into the toilet. (If the patient is on bed rest, allow the
colostomy to drain into the bedpan.)
13. Close the colostomy irrigation drain pouch with a rubber band
or pouch clip, then ambulate the patient, or return him/her to
bed.
a. Ambulating stimulates elimination, producing improved
irrigation return.
b. Have the non-ambulatory patient lean forward or massage
his/her abdomen to stimulate return.
14. Wait approximately 1 hour for the rest of the colostomy
return, then remove the irrigation drain pouch from the
patient.
15. Gently clean the area around the stoma with mild soap and
water.
a. Be careful not to rub the skin.
b. Rinse and dry the area with a towel.
16. Provide for the patient’s comfort; remove and dispose of used
supplies.
Nursing responsibilities after the procedure
17. Document findings
a. Record the procedure and significant nursing observations in the
patient’s clinical record and report it to charge nurse.
1) Note color and condition of stoma and peristomal skin.
2) Record color, consistency, and amount of drainage.
3) Note amount of irrigating solution used.
18. As recovery progresses, the nursing personnel should
gradually assume a more passive role in colostomy care,
allowing the patient to assume the active role.
____________________
Clinical Instructor
