[kc319]

I have a pt with a transverse colostomy who will be undergoing a colonoscopy. She is to have enemas given to her through her colostomy and I've never done, seen it, nor been inserviced on it! Can anyone explain the procedure to me?

[sharlynn]

Evidently they don't teach colostomy irrigation in nursing school anymore! It's basically like a soap suds enema. There is a special bag to apply for a colostomy irrigation. The bag is longer than a colostomy bag and the return can flow right into the toilet if the patient is able to sit on the toilet, otherwise into some other container or bedpan. There are ports at the top to insert the enema tube.
I haven't done one in years!

[riverrose]

My patient (supposedly) hasn't had a bowel movement in 6 days. Bowel sounds are normal. The off going shift told me to do an enema. But I was leary about doing one with the colostomy...Everything I could find on the internet was against giving an enema? But there was alot of irrigation. So my question is "Is it safe to give the enema?" If you can irrigate, why not an enema? Your suggestions will be greatly appreciated.

[Diary/Dairy]

Irrigation is not as much used as it used to be....

[oldiebutgoodie]

Irrigation is done with a special short cone-shaped end (called a stoma cone) to the irrigation tubing. This is designed this way in order to 1) keep the fluid being instilled from leaking out, and 2) making sure that the colon is not perforated.

Here is a link to a picture:

http://www.walgreens.com/store/produ...id=prod3398909

An enema done through a stoma with a standard enema tip could perforate the bowel, because the bowel to the stoma may be at an angle.

Is there an actual order from the MD for an enema through the stoma? If so, I would contact the WOC nurse to do it or at least give you tips.

When I have had patients with a colostomy and constipation, we either used a soft 16 french catheter and instill mineral oil through the stoma (which did not resolve the probem) or used a laxative (orally), which did resolve the problem.

Hope this helps,

Oldiebutgoodie

[riverrose]

Thanks immensely, oldiebutgoodie!! It was helpful!!

[Lifespanz]

It should be taught
I have put together a video have a look
http://video.google.com/videoplay?do...OZD6qQPVjO2zCQ
or go to Google video and put colostomy irrigation in the search area