Last week we posted about controlling your ostomy output via using irrigation to train your body to empty at specific times. Today we would like to elaborate as to when irrigation works and how.
Obviously different ostomy surgeries produce different varieties of output. This is largely due to the location of the ostomy and the stoma. One of the colon's functions is to absorb water from the contents of the bowel. As such, the more colon that is left intact after your surgery, the more solid your discharge is going to be and the more predictable as well.
Since an ascending colostomy removes more of the colon, it is likely to result in more fluid-like stools with frequent and unpredictable evacuations. A transverse colostomy typically results in soft to pasty stools that are still unpredictable although they are not as frequent as the ascending colostomies. The descending, or Sigmoid, colostomy typically retains more of the colon in place in the body and as a result will generally produce one firm well formed stool a day. As we wrote about last week, combined with consistent diet, eating habits, and irrigation, this can usually be trained to be completed on a regular schedule as well.
Regardless of the type of colostomy, a skin barrier should be used around the stoma to best protect the skin and to provide a leak-proof seal with your pouch or cap. Typically an ascending or transverse colostomy is best treated with a drainable pouch due to the frequent discharge and the need to empty the pouch on a regular basis. With a descending or Sigmoid colostomy, a stoma cap may be worn between irrigations and either a closed pouch or a drainable pouch can be worn as the stool is generally well formed.