Irrigations much slower over the years - anyone else?

[kitmcc]

Hi,

I haven't been on the forum for a while but have been so grateful for it over the years.

Here's my problem for which I'm seeking help. Been irrigating since 2003. Starting a few years back (maybe 2011) it began taking 90 minutes instead of 60, then 120 instead of 90, and now clocking in around 3 hours. Anyone else have this experience? I've googled and searched the site and, weirdly, I didn't find others.

I've tried the usual suspects without any improvement: single and double infusions; increasing fluids throughout day, the night before and just before, increasing fiber (I eat plenty, but added citrucel just to see). I work out 3-4 days a week and am a fit and active 60+ year old with no health issues.

So far, nothing makes a difference. Colon is fine (just had colonscopy). I've never had blockages. The super-sized laxative dose in colonscopy prep did not fail to empty things out. GI doc thinks maybe it's constipation, but like clockwork my colon tells me it's ready to go in 2 days, max 3, so I dunno. Other TMI -- I have always irrigated in the morning, before or after a workout, so I haven't changed that up... yet. And I do usually stream shows during a session to while away the time, a switch from reading in recent years. Who knows, maybe the news each day is a more peristolis-inducing choice.

All thoughts welcome. (except quitting irrigation -- never gonna happen unless I absolutely cannot.)

Thanks in advance...

Kit

[ot dave]

Hey Kit,

I'm 45 and a daily gator for 7 years now. Just had a parastomal hernia repair last July, which kind of made things all new again as 6 more inches of my colon was removed as it was deemed too long anyways. That said, my irrigation is finally getting back to "normal" for me.
Anytime I have issues, my problem is that the water won't go in. Never had it take a long time, except when the water was too cold.

The only thought that comes to mind is water temperature. If my water temperature is too low, I almost always have issues with time of infusion. Are you using warm water? I like to use warm, if not hot water to irrigate with. It gets in there and helps the colon to expand (due to heat), which helps to stimulate peristalsis, and I have found that it will break up hard output that isn't very mobile. Disclaimer: When I say hot, I make sure that I can stand the heat of the water on the back of my hand. You don't want to burn your colon! I don't know if this is something you've adjusted, but hopefully this will help.

Hope you find and answer.

David

[Jimbob]

I have been irrigating since 2005, I sometimes have to spend more time with the process.

What I have been doing lately is waiting an extra day and then it seems like it works better. I also just had a colonoscopy and all was well with my colon.

Maybe it has something to do with motility slowing as one gets older. Everything else is slowing down, why not that??? I just turned 75, Tempus Fugit...

[steiconi]

I've only been irrigating about a year and a half; irrigation times range from less than 10 minutes to over an hour. I keep puzzle books in the bathrooom.

I'm quite gung-ho on new ideas, and sometimes overdo. When I read about using hot water, I started using the hottest I could stand...and suddenly needed to change my wafers more often (every 2-3 days) because the eakins rings were dissolving faster. Now I'm using comfortably warm water, and getting better wafer time (5-6 days).

Lesson: try new things, and keep track of results so you can adjust as needed.

[kitmcc]

Thank you, everyone, for your thoughts and ideas. I use warm water -- just tried it warmer. Also waiting an extra day. Not sure how well that will work yet but if indeed motility is slower with age and it's gonna crawl after learning to walk-- well, I might as well spend that 3 hours just 3 times a week.

I guess I'm wondering about taking a laxative the night before -- I hate to, I've never taken them. But I remember reading way way back on this or its predecessor site of someone doing that, er, regularly.

till later,

Kit

[ot dave]

Have you considered trying a daily irrigation? Maybe if you did it more frequently, the output wouldn't get so "packed" that it would be easier to move on a daily basis. Just throwing out ideas. I know that when I intentionally make my output more thick by using immodium and lomotil, that my next couple of irrigation sessions are slower as it takes more water to "loosen up" what had been in there for a couple of days. Might be worth a shot.

David

[Mikem]

Hi Kit,

Interesting topic. One that I have been dealing with for a few years.

Same age, not particularly trim or fit but I do a short stretch and work out most days for about 45 minutes. As a practitioner of multiple infusions (4) every other day, I am generally in the room for no less than two hours and sometimes up to 3 if I am not in a hurry. Typically in the evening on Sunday, Tuesday, Thursday nights with a short session sometime Saturday.

I can change that by adding a timer and infusing every 15 minutes (prior to getting complete returns). The results of that are mixed but generally successful. I am not consistent with trying to regulate it that way. Like you I keep myself busy with a tablet reading, playing games or watching movies or videos which I find more comfortable. I suspect that is the root of the problem.

While we are also likely suffering from typical bowel aging which affects everyone differently, my bet is that I am too comfortable with an extended routine.

One thing I think you should consider if timing is an issue is that you are too comfortable with your routine. If you eliminate the “entertainment” and perhaps even irrigated while standing up, I suspect you might train your body to go about its business more expeditiously. I have not been motivated to try that aggressively. My attempts found that it is extremely boring to concentrate just on the irrigation process.

Another thing to consider is to temporarily stop irrigating and see if you can reset your clock. That has never lasted for longer than 24 hours the numerous times I have tried it.

Good luck.

MikeM

[steiconi]

I was kind of slow tonight, so I shaved my legs. That always helps, as the bending and twisting puts pressure on my bowels.

I'm not suggesting you shave your legs, but you might try bending and twisting. Most effective seems to be *twist to the left and bend over*.
Also, it seems that sometimes the belt holding the sleeve gets too tight on the left side, and loosening releases the flow.

One more thing...before the ostomy, I had to do enemas every night. Castille soap is recommended for enemas to help release clumps. I sometimes use liquid soap in the irrigation bag if I'm feeling constipated. Note: although Dr. Bonner's Peppermint Soap is castille, DON'T USE IT. The peppermint is just too refreshing to use internally.

[kerrels]

Hi, I had a colostomy in 2012 and have been irrigating since 2013, everything was going great, and my life was a lot more normal. I go camping all the time and irrigate along the way, using tips picked up on this forum years ago.

Unfortunately I developed a parastomal hernia, and with that, I'd get blockages, which became more frequent and lasted for longer. So I had a hernia repair and a "stomal re-fashioning" in December. Basically about another 6 inches was removed and I got a totally new stoma.

Apart from the fact that my new stoma is flush to the skin so I need different appliances, I am also finding that irrigation no longer works. The water goes in and comes straight back out, clean, so it clearly isn't getting in and staying in. My stoma nurse suggested trying a Foley catheter to irrigate with - its made of silicon and very flexible. There seems to be some sort of resistance soon after it goes in, so I think there's a kink or a sharp corner, which would explain why the water didn't stay in with the cone.

Has anybody else ever tried this?

Since the catheter is much thinner than the cone, and not conical, it doesn't form a seal, so I have accepted that quite a lot of water comes out straight away. I am finding that the results are nowhere near as consistent as I was used to, I can't rely on having a good irrigation that will last until the next day. Usually it doesn't. Quite often, nothing comes out. Since the catheter is so flexible, I am convinced that sometimes it doubles back and sends the water straight out, so nothing much happens.

If anybody has had any experience with using a catheter for irrigating or has any suggestions, they would be most welcome.

[kitmcc]

I'm back with a report! I compiled the great suggestions and so far my irri's are down to 1 hour (45 minutes today!). Here's what is working:

1. Irrigation daily. (Thanks, Dave!) I tried skipping a day, which made sense, but that was a fail. Body seems to like it the way it was in the original plumbing days, that is, daily. Aside from taking less time, it's a nice feeling of lightness. At the beginning of the new daily routine, I did feel more sensations about my guts, due to the increased stimulation (irritation?) I assumed. Reducing the initial infusion from my usual 1.5L to under 1 seems to help on that score. (see #2)

2. Multiple infusions. (Thanks, Mike!) I meant to post back to ask you how much water every 15 minutes. I ended up trying a bit less than a liter at first, then 1/2L 15-20mins later, and another 1/2L 15-20 mins after that. The trick seems to be waiting for a pause in output, but not too long.

3. Ditch the ipad. (Thanks again, Mike -- you grounded my suspicion about 'entertainment' not being conducive to getting the job done. (Maybe it's the screen itself too. Sort of disembodies a person.)

4. Twist left and bend. (Thanks, Lee!) I noticed that my watching/reading position had me turned slightly to the right. So, I switched to the other direction. And did a few simulated leg shaves. Definitely a keeper.

It's been a few weeks and I'm optimistic that I've cracked it -- but I'm well aware the body has a mind of its own! Thanks again.

P.S. Kerrels - I don't know what to say about a Foley catheter, since I've never tried one. Maybe copy your post to a new subject if you get no further responses here? Good luck!!

[Pisces]

I'm back with a report! I compiled the great suggestions and so far my irri's are down to 1 hour (45 minutes today!). Here's what is working:

1. Irrigation daily. (Thanks, Dave!) I tried skipping a day, which made sense, but that was a fail. Body seems to like it the way it was in the original plumbing days, that is, daily. Aside from taking less time, it's a nice feeling of lightness. At the beginning of the new daily routine, I did feel more sensations about my guts, due to the increased stimulation (irritation?) I assumed. Reducing the initial infusion from my usual 1.5L to under 1 seems to help on that score. (see #2)

2. Multiple infusions. (Thanks, Mike!) I meant to post back to ask you how much water every 15 minutes. I ended up trying a bit less than a liter at first, then 1/2L 15-20mins later, and another 1/2L 15-20 mins after that. The trick seems to be waiting for a pause in output, but not too long.

3. Ditch the ipad. (Thanks again, Mike -- you grounded my suspicion about 'entertainment' not being conducive to getting the job done. (Maybe it's the screen itself too. Sort of disembodies a person.)

4. Twist left and bend. (Thanks, Lee!) I noticed that my watching/reading position had me turned slightly to the right. So, I switched to the other direction. And did a few simulated leg shaves. Definitely a keeper.

It's been a few weeks and I'm optimistic that I've cracked it -- but I'm well aware the body has a mind of its own! Thanks again.

P.S. Kerrels - I don't know what to say about a Foley catheter, since I've never tried one. Maybe copy your post to a new subject if you get no further responses here? Good luck!!

Hi,

I haven't been on the forum for a while but have been so grateful for it over the years.

Here's my problem for which I'm seeking help. Been irrigating since 2003. Starting a few years back (maybe 2011) it began taking 90 minutes instead of 60, then 120 instead of 90, and now clocking in around 3 hours. Anyone else have this experience? I've googled and searched the site and, weirdly, I didn't find others.

I've tried the usual suspects without any improvement: single and double infusions; increasing fluids throughout day, the night before and just before, increasing fiber (I eat plenty, but added citrucel just to see). I work out 3-4 days a week and am a fit and active 60+ year old with no health issues.

So far, nothing makes a difference. Colon is fine (just had colonscopy). I've never had blockages. The super-sized laxative dose in colonscopy prep did not fail to empty things out. GI doc thinks maybe it's constipation, but like clockwork my colon tells me it's ready to go in 2 days, max 3, so I dunno. Other TMI -- I have always irrigated in the morning, before or after a workout, so I haven't changed that up... yet. And I do usually stream shows during a session to while away the time, a switch from reading in recent years. Who knows, maybe the news each day is a more peristolis-inducing choice.

All thoughts welcome. (except quitting irrigation -- never gonna happen unless I absolutely cannot.)

Thanks in advance...

Kit

Hi!
It's my first time to comment and I don't know where to type my question. Anyway, I am corresponding on behalf of my husband who has an Indiana pouch. He panicks everytime he has a leak. Although after reading everyone's post I noticed most of you has had leaks even if you guys cath as often as 3 hrs. He cath's every 6 hrs despite the doctor recommending every 4 hrs. We didn't know anything about irrigating the pouch. Where can we find instructions on irrigation and the kind of water to use. I am thinking it might help to irrigate it.

Pisces

[Jimbob]

Hello Pisces;

For information read the first two posts on the irrigation forum for detailed information on irrigation. And welcome to the forum.

[Bob Webtech]

Hello Pisces,

I'm afraid you posted in the wrong part of our discussion board. This forum ("Irrigation Option for Colostomates") is for irrigating a colostomy, which is a type of fecal diversion (not urinary diversion). An Indiana pouch is a urinary diversion and is, moreover, classified as a "Continent" Diversion, so you would do best to post in our Continent Diversions forum. Also, depending on the nature of your question, it may be best to post it within that forum as a new topic, instead of a reply in an existing topic.

Note that, even if a form of "irrigating" is sometimes appropriate for an Indiana pouch, it's very different from irrigating a colostomy.

[autodraw]

Hi Kitmcc,

I just noticed your post re slower irrigations. I too experienced this after years of easy and predictable irrigations (I started irrigation the same year you did, 2003) Poor results started about 6 years ago after an unpleasant bout with a perforated colon (high risk polyp removal). The resultant miserable 5 day stay in hospital with peritonitis seemed to have affected irrigations, which grew slower and slower. What used to take under an hour began to take up to two and longer, with less clear time after. Frustrating and perplexing!

Suddenly, irrigations are working again, here's what I changed: In January of this year I started doing three infusions of 1,000 cc each rather than four of 750 each (I've always needed a LOT of water, infused in stages) The other thing that changed is because I'm lazy as hell and skip the gym far too often, I decided I should at least do crunches every day at home to keep the abs toned. So I do, 60 per day, every day after my shower. It might be coincidence but I like to think the crunches have helped. So now it works very well again, and I'm usually done in under an hour, with two days clear time the norm. If this doesn't last, I'm still going to irrigate. It's still worth the effort!

Best of luck, hope you can turn this around!

[Jimbob]

Where have you been Autodraw. I have missed the Fairy Godmother of Irrigation.