Colonic/ Colon Irrigation PDF

Colonic / Colon irrigation Definition Colon or colonic irrigation is also known as hydrotherapy of the colon. It is the process of cleansing the colon by passing solutions through it with the use of special equipment and should only be undertaken by a qualified practitioner. Aims of colon irrigation...

Colonic / Colon irrigation Definition Colon or colonic irrigation is also known as hydrotherapy of the colon. It is the process of cleansing the colon by passing solutions through it with the use of special equipment and should only be undertaken by a qualified practitioner. Aims of colon irrigation: ​ To clean the distal portion of the bowel. ​ To dilute & remove any of the toxic agents that may be present in the large intestine. ​ Decompress the bowel and deflate the abdomen by removing air and faeces. ​ Used as a mode of temporary treatment for Hirschsprungs ​ To relieve low intestinal obstruction. Indications of colon irrigation: ​ Preparation for diagnostic testing ​ Neurogenic bowel dysfunction due to spinal abnormalities, spinal cord injury, or cerebral palsy. ​ Children with sequelae of anorectal malformations or Hirschsprung disease. ​ Fecal incontinence due to iatrogenic injury (including tumor surgery sequelae). ​ Medical therapy–resistant functional constipation. ​ Medical therapy–resistant functional fecal incontinence. Contraindications of colon irrigation: ​ Loose sphincter ​ Painful skin lesions around the anus (Fistula in anus) ​ Known anal or colorectal stenosis ​ Ischemic colitis ​ Severe cardiac disease ​ High not controlled blood pressure) ​ GI hemorrhage or perforation ​ Carcinoma of the colon  ​ Abdominal hernia ​ Recent colorectal surgery )Within 3 months ​ Active inflammatory bowel disease such as: Diverticulitis, Ulcerative colitis. Risks associated with colon irrigation ​ There is a risk of reabsorption of saline, especially if most of the solution is not expelled (retention of instilled solution). ​ Infection due to unsterile equipment that permits backflow of fecal material to the water system. ​ Exacerbation of chronic bowel disease such as diverticulitis. ​ Reduced capacity to control bowel movements for a period of time after the procedure. ​ Removal of normal intestinal flora may lead to gastrointestinal infections. ​ Injury to the colon, such as ulceration or perforation. Warning signs to stop the irrigation Stop the insertion of fluid if any symptoms of distress appear such as: ​ Abdominal pain / cramps ​ Nausea, vomiting ​ Shortness of breath ​ Chest pain. Note: It is important to observe the volume between instillations of saline solution drained from the catheter into the basin; you should have the same amount of instilled solution plus stool in the basin. This process is very different than an enema, which introduces the fluid but does not allow it to passively come out. Instructions to avoid complications ​ A cleansing enema should be given 1 hour before the colon irrigation is started, so that the rectum will be free of fecal matter. ​ The bladder should be emptied before a colonic irrigation to reduce the intra-abdominal pressure.  ​ The temperature of the solution kept constant throughout the procedure. ​ Do not allow the air to enter into the intestine by expelling the air from the tube. Instructions must be followed during procedure of colon irrigation: ​ The mother should be instructed to not feed the infant/ or child is asked to not eat before colon irrigation. ​ Inserted distance of the catheter ranges approximately from 4 - 6 inches (10-15 cm); depending on the child's weight. ​ Massage the lower abdomen during the colon irrigation. ​ Temperature of solution used in colon irrigation should be close to body temperature (36.8 C–38.8C). ​ The lowest volume of solution should be used that achieves the desired effect is 10 to 20 mL/kg. Colon irrigation is delivered in a 30 to 45 min session.