Guide to Colostomy Irrigation

A colostomy connects the colon to the surface of the abdomen and allows waste material and gas to leave the body. Colostomy irrigation is a way to regulate bowel movements by emptying the colon at a scheduled time. The purpose is to empty your bowel at the same time each day. Colostomy irrigation also helps to avoid constipation and regulate bowel movements. After the procedure you may stay free of drainage for next one to two days. The process involves putting water into the large bowel (colon) through the stoma. The stimulation provided in the process empties the colon.

            Guide to Colostomy Irrigation                      

Who should Perform Colostomy Irrigation?

Ostomy patients with permanent colostomies and patients whose stoma opening is in the descending or sigmoid portion of the colon are fit for irrigation. This is because their stools tend to be more formed. People with irritable bowel syndrome, stomal problems, or stomas in the ascending or transverse colons are not recommended to undergo irrigation of colostomy.

What is the Best Time for Colostomy Irrigation?

The most effective time for colostomy irrigation is about one hour after having a meal. It is recommended to irrigate at about the same time each day. Later you may change the time that works best with your schedule and bowel habits. It is best to irrigate when you are most relaxed and make sure no one interrupts you. There is no fixed interval for ostomy irrigation, some people prefer it once a day or once every other day depending on their preference and ability to regulate bowel movements. However it is important to establish a routine and irrigate about the same time every day. It generally takes about six weeks to eight weeks for the bowel to become regulated with irrigation.

Required Colostomy Irrigation Supplies

Colostomy Irrigation Procedure

Colostomy irrigation takes up to 1 hour. Follow these steps to irrigate your colostomy: 

  1. Choose the ostomy pouch that fits your ostomy. Connect the tubing to the irrigation bag and close clamp.

  2. Fill the irrigation bag with lukewarm water upto the 1000 cc mark.  Make sure the water is not too cold or hot. Safe drinking water can be used for irrigation. The speed of water flow into your stoma will depend on the quantity of water you use. For 1000 mL of water, it will take about 10 minutes. If the water stops flowing it is recommended to change to position of the cone.

  3. Open the clamp and let water run through the tubing. It will flush out the air out of the irrigation tubing.  Close the clamp. Make sure there is no left over air since it can cause severe cramps and swelling.

  4. It is best to hang the irrigation bag so the bottom of the bag is at shoulder height when you sit down. You can attach a permanent hook to the shower curtain rod.

  5. The easiest way to irrigate is to sit on the toilet or on a chair in front of the toilet. Place a towel across your lap if you are sitting on a chair, this will support the irrigation sleeve.

  6. Attach the irrigation sleeve to the mounting ring with the locking ring.

  7. Remove your old colostomy pouch. Wipe the mucous and/or stool from the stoma area with a tissue or washcloth.

  8. Attach the irrigation sleeve and the ring around the stoma site. Secure the rings with your belt. The end of the sleeve should skim the top of the water in the toilet. This will prevent splashing. You can also cut the sleeve if it is too long.

  9. Lubricate the cone with the lubricating jelly. Vaseline or any other moisturizer is not recommended.

  10. Start from the top of the irrigation sleeve. Gently insert about one-half to two thirds of the lubricated cone into the stoma. If you have a hard time inserting the cone, relax for a while. It sometimes happens due to anxiety and harder than normal stool. If water back flows around the cone or does not flow into your stoma, gently change the angle or position of the cone. Keep adjusting until water flows and there is no backflow of water. If this doesn’t help, remove the cone from the stoma to allow stool to flow from your colostomy. Don’t apply force on the cone.

  11. Once the cone is in place, open the clamp and let the water flow slowly into the colon. You may feel some minor cramping. If the cramping becomes severe, stop the flow of water and wait for the cramping to stop. When the cramping stops, open the clamp and start a slow flow of water again.

  12. After all the water has entered the colon, pull the top of the sleeve up over the stoma and remove the cone. At first you will have a large outflow of water and stool. After most of the fluid has returned, you can rinse the inside of the sleeve with cool tap water. Most of the fluid will return within 15 minutes.

  13. Fold the top of the irrigating sleeve over and close the bottom of the sleeve by folding it over. Use the two clamps in the kit to hold the sleeve closed. After most of the fluid has returned, you may continue your routine activities. Activity and relaxation may help elimination. It takes about 30 to 45 minutes to complete the irrigation.

  14. When you feel as if you are finished, go back to the toilet. Unclamp and empty the irrigation sleeve. Rinse it out with cool tap water.

  15. Remove the mounting ring and sleeve. Clean the stoma and the skin around it. Don’t apply pressure or rub the area. It is normal to see flecks of blood after the stoma has been rubbed or opened.

  16. Apply your ostomy pouch in the usual way.

  17. Wash the irrigation sleeve and the mounting ring in cool clear water and dry it. The reusable supplies can be saved for next time.


Important Tips -

  • It is best to irrigate at the same time each day.

  • Never rush the procedure.

  • Irrigation may be more helpful if it follows a meal or hot drink. The most suitable time is one hour after the meal.

  • In case of cramping, relax and take some slow deep breaths. Gently rub your abdomen, it will help relax the muscles. Inappropriate height of the irrigation bag, rapidly flowing water and cold water can be the cause of cramping. To relieve the cramps remove the stoma cone and allow the bowel to empty. If cramping is severe or persists, call the doctor immediately.

  • It is advised not to irrigate if you have diarrhea.

  • Do not irrigate if you suspect having hernia.

  • It is not recommended to irrigating during chemotherapy or radiation therapy.


Hygiene is the most important factor to be taken care of in this procedure. Make sure everything is properly cleaned and securely placed in clean dry environment. Being relaxed and calm helps alot. Some people prefer listening southing music to avoid the distraction and anxiety. With practise the irrigation process becomes smooth. Consult the doctor if you feel uncomfortable or incur any kind of pain. Keep the emergency number ready in case of urgent help.