Setting Myself Up For Success

[AaronMSB]

Hi Everyone,

I've been lurking here in the gator forum since shortly after my colostomy in July 2016. Originally I decided not to irrigate because I have Crohn's disease and was thinking that I wouldn't get the benefit of irrigating. However, my bowels have gotten a lot more regular lately and primarily they decide to empty themselves at night. I usually start having a movement right about the time I lay down to sleep. Or I'll get to sleep and then wake up to a super full bag.

So I'm thinking about irrigating to keep myself from having to get up 2 or 3 times a night to empty my bag. I'd like to set myself up for success so I have a few questions for the experienced folks among you.

1. I'm currently receiving chemo, assuming my blood counts are okay, are there any reasons this would be a problem? (obviously I'll mention my irrigation plans to my doc to make sure he has no objections).

2. From time to time I have small bowel obstructions. The docs seem to think that this is caused by adhesions (scar tissue) left over from my APR surgery. When I irrigate do I have to worry about trapping water behind an obstruction and making things worse? Does water even get to the small intestine when we irrigate?

3. If my normal bowel movement is during the night, what time should I irrigate? Right before bed? Can I get away with irrigating earlier, like 6pm?

4. Do any of you have experience with moving the time of your irrigation from evening to morning or vice versa?

[steiconi]

3. I irrigate a couple hours before bed and usually have no output for at least 24 hours; some people boast of up to 3 days pooh-free. It varies by person, so you'll have to try it and see.

4. It's usually a good idea to start irrigating at about the same time you usually have a bowel movement. There have been discussions here of changing the timing, and it always seems to be OK.

2. I'm not sure how far the water goes. It would probably depend on how much water you use, plus how high the irrigation bag is hung (that affects the water pressure). Also would depend on how much large intestine is left. FWIW, When I've had a SBO, irrigation doesn't clear it.

1. I would guess that irrigating during chemo wouldn't be a problem, but it is a good idea to check with doc.

[ot dave]

Hey Aaron,

Irrigation is going to be unique to each individual. I didn't start irrigating until about 6 months after finishing chemo. That said, it didn't mean that I couldn't. Chemo plays havoc on your bowels. You'll go from constipated one day to full blown diarrhea the next. The consistent effectiveness of irrigation won't be perfect. You'll just have to weigh the cost to benefit ratio for your time involved.
As for small bowel obstructions, irrigation shouldn't impact those. There is a valve, the ileocecal valve that is designed to prohibit the reflux of fluid from the large bowel to the small bowel.
As far as time of irrigation. You can make that individual to your lifestyle. I irrigate in the morning as that fits into my schedule better. But, my body was used to having bowel movements late in the day...usually after eating dinner. I was able to get my bowels to adjust. If the evening works better for you, try it then. Just remember that the first time you perform this, to give yourself some time for unforeseen events, and to be able to relax while you are doing it. The more relaxed you stay, the more effective it will be for you. I am a hunter, and routinely leave the house very early in the morning. Obviously I can't dedicate time to irrigating in the morning on those days. When this occurs, I frequently will irrigate the evening before, and use immodium to help slow things down. I don't recommend immodium for you if you are having small bowel obstructions though...don't want to irritate those issues. So yes, I do move irrigation times based upon my lifestyle.
Be patient with the process. I might even suggest waiting for chemo to be completed as it does so many things to your bowels.
Hope some of that helped.

David

[AaronMSB]

Thank you David and Lee for your thoughtful and thorough replies.

I'm looking forward to givging this the old college try. I did do a few nurse-assisted irrigations in the hospital. One with disastrous results. The second went okay, but I wasn't able to get much water in. Now that I think about it, what you say about stress was probably the culprit.

Thanks again,
Aaron

[ot dave]

Aaron,
When you do get ready to start, check out this youtube video: https://www.youtube.com/watch?v=g14kbuw1fU8

There are other videos there that are quite helpful as well, but this was the one the gave me most of the ideas/tricks that I use to irrigate. I've irrigated in family member homes, friends homes, hotels, a live aboard boat, and 10 days in a tent while in Colorado elk hunting.

Come back and ask as many questions as you need to. The gators will show up in force!

David

[steiconi]

After reading David's comment, I remembered that I did enemas every day during chemo (that was pre-ostomy, when I was still struggling with an unresponsive rectum). I don't remember problems with diarrhea or constipation during that time, so maybe the enemas (which are simply irrigations through a different orifice) prevented those issues.

[AaronMSB]

Awesome. Thanks, Lee.