Today's colostomate has a choice: to let the digestive tract continue its work as originally designed, without interference, or to wash out the waste materials while they are being held in the descending colon.
Those who choose to "let nature take its course" can maintain cleanliness by choosing one of a variety of pouches available on today's market; worn outside the body as an attachment to the stoma, the pouches are simply storage areas which substitute for the rectum.
They can be emptied, rinsed and left on for additional waste collection or, if necessary, thrown away as filled. They must not, however, be flushed down the toilet, as they will certainly clog the plumbing! [unless using one of the new "flushable" pouches--Ed.] The second option, washing out the fecal matter before it is excreted through the stoma, is known as "irrigation."
In a way, "irrigation" is nothing more than "irritation," producing a "gut reaction" that forces out the contents of the intestine.
Why should water do this? The digestive tract is designed as a one-way street from mouth to anus. When water is forced into the colon through a stoma, it is going the wrong way, so the gut clamps down in an effort to get rid of it. If fecal matter is also present, it too is forced out with the water. Voilà. An effective irrigation!
To insure a successful irrigation at any time, there must be fecal matter in the descending colon. To be certain that irrigation is going to be successful, one should keep a record of the average time after a meal that the gut empties at the stoma. The record should be kept long enough to be certain of a realistic average.
An important hint about irrigation: be careful not to force too much
water into the descending colon. At least
This is not a mere matter of personal preference! Though the gut does not have touch-pain receptors, it does respond to distention. If distention is too great or occurs too often, the muscles in the colon get tired of complaining and lose their elasticity. This condition can be a serious problem but is easy to avoid by being careful to control the supply of irrigation water.