Bowel control after a Colostomy depends in part on the nature of the colostomy and in part on the nature of the person. Patients with right-sided colostomies do not have as much remaining colon as those with a left-sided colostomy. Because of this, there is usually too little colon left to absorb enough water to make a solid stool. This type cannot be controlled by irrigation, but instead behaves very much like an ileostomy with a fairly continuous discharge.
The sigmoid, or left-sided colostomy, is often described as a dry colostomy because it discharges formed stool. One has the choice of attempting to manage this type either by trained control or irrigation control. Only one-third of the people who attempt to train themselves to control their colostomy without irrigation are successful in doing so. This type of training relies very heavily on diet and medications to achieve regularity. Most physicians in this country feel that control is more easily and satisfactorily achieved by irrigation.
However, there are some patients who cannot achieve irrigation control because they have an irritable bowel. This problem has nothing to do with the colostomy. It's just part of some people's makeup. Some people, even before they had their colostomy, may have had very irregular bowel habits. They may retain their habits after their colostomy is performed so that regular irrigation does not assure them regularity. When this condition exists, physicians will sometimes suggest the patient dispense with irrigation since it will not produce the desired regular pattern, and the person may become frustrated trying to achieve this.