Irrigation with hernia around stoma - any advice?

Hi everyone! I hope you are all doing well or better. I would like to return to irrigating, but I have developed a hernia around my stoma which is rather large. I plan to look into a repair in '15. Anyway, I'd like to know if it is okay to irrigate with a hernia around the stoma. Does anyone have experience with this you'd like to share? Thanks bunches! XO!

Hi

Someone else asked me the same thing one time... I did not know... as they had a hernia and wanted to know about irrigation...

In this PDF file; which is a good explanation on irrigation, you will find in section 15; information on irrigating with a hernia... Seems it is possible... but maybe some on here are doing it and can give you some tips... Good luck...

http://www.ostomy.org/uploaded/files/ostomy_info/Irrigation_FAQ.pdf?direct=1

I successfully irrigated with my hernia for a few years, it can be done but it's a little tricky and the results are not always as reliable. My hernia got large enough that I reluctantly had it repaired. The repair required relocation of the stoma and a lifestyle change - no lifting over 50 lbs. I would recommend the repair only if you can commit to the limitations, as a large number of repairs fail. Choose your surgeon carefully, I saw 3 before I chose one who I felt confident with. Mine was Dr. Aston of Nashville. I can provide his contact info if desired. The first few months post-op were disheartening as the repair site was swollen and I had trouble getting a good seal. The doctor assured me that the area would "flatten out," which it did. I have no problems now and the irrigation works great on the new site. Be prepared to be off work long enough to allow for everything to return to normal. Good luck.

Hello bmeup.  Thankfully I can still irrigate with a hernia but it needed one or two experiments and adaptations in order to do it successfully.  Firstly, my hernia spreads across the inside of the opening to the stoma like a sliding trapdoor stopping everything going in or out.  After discussing it with my stoma nurse, followed by much trial and error, I found that the muscles could be 'trained' to recede and open up the hole by inserting a finger and keeping it there until the peristalsis more or less gave up working. The irrigation cone could then be inserted without a problem. (This is also the case with inserting plugs afterwards.) For some years now I've been using pressurised water to help the cone past the hernia -- I use a 3 litre 'killer-spray' that was redundant from the garden shed!! and have adapted it to take the Coloplast valve and cone. The jet of water seems to make the hole open sufficiently for the cone to make its way past the hernia without too much of a problem. (There is a 'proper' gadget on the market for this type of thing and I did a review on it some time back). The second point I would make is that the bulge from the hernia sometimes makes it difficult to get and maintain a proper seal on the flange.  This is really irritating as I only realise that the seal is broken after I've put the water  into the stoma and it is then not ideal to think that I can change the faulty irrigation sleeve for one that may or may not be better.

Anyone who irrigates will tell you that a proper seal is essential if you don't want to be dealing with a high pressure spray of faeces all over your bathroom. I have several 'gadgets' to cope with faulty flanges at that critical time.  The most effective of these is a snug-fitting device made from a small piece of plastic skirting with a plastic waste-bend glued into a hole in the middle of it. After I've put the water in, this device is placed over the stoma and inside the irrigation sleeve. It is secured top and bottom with two 'string' belts that go right round the waist.  The faeces then spurts into and round the bend and is directed downwards into the sleeve rather than straight out and splattering uncontrollably against the sleeve wall. The baseplate/skirting presses against the inside of the sleeve-flange and creates the necessary seal. I've tried all sorts of other, more ingenious ideas, but none of them work quite as well as the simplisic one described above.

Personally, I cannot imagine how I would cope on a daily basis if I couldn't irrigate and I empathise with all those of you who have no option but to use bags. I hope this is of some help in answering your question.  Best wishes  Bill

Thanks for the link. It was very helpful. I'm relieved to know that given my circumstances, it is not a complete no-no.

Words of Encouragement from Ostomy Advocates I Hollister

Hey super hero, thanks for the input and info about your own experience with a hernia repair. I am also very reluctant about it and will not make the decision lightly. If I can find a more comfortable and attractive way to live with this thing and be able to irrigate, I think I'll feel a lot better. Sounds like the recovery is a bit rough. I will be sure to talk to more than one surgeon because I am currently going through targeted chemo, as well. Did you have the graft repair or the old standard? I'm curious because I've heard bad things about the graft. Thanks!

Bill, it sounds like you need to patent some of your ideas! I can understand how the downspout type of thing works, but I can't quite picture it. Maybe a photo would help me out. As for irrigating, I had just started last year and then this hernia made it very difficult. I decided to halt until I could get some trustworthy advice. I have experienced the "wall" around the stoma you mentioned and feel relieved to know it can be overcome. Irrigating was infinitely better than having to deal with the pouch every day. So thanks again for the advice.

My repair was with the pig skin mesh. My doctor was a young fellow, but he suggested the pig skin as he felt it was the best "long term" solution. Regards. MMSH

Hello bmeup.

I would be very pleased to send you a photo -- if ony I knew how to do it!

I have now looked on FAQ and found the answer to posting photos - so I have put one on 'my profile'.

Don't be put of by the 'heath-Robinson' look of the gadget as all my gadgets are prototypes made up of anything that may be handy in my shed! 

You can just see two holes on the baseplate either side of the spout. this was where the other two 'eyes' were for the second string-tie. However, this didn't work very well as the strings go on the outside of the irrigation sleeve and the bottom line would have either blocked the outlet or have to be pierced through the sleeve which would leave it liable to leakage.  Hence the bit of black plastic stuck on the outside of the spout which allows a belt to be tightened round the whole gadget without interfering with the spout outlet. It works perfectly well with just the belt but I always put the top string on as well for 'safety' reasons.  I didn't like the idea of having to fish about down the loo for it if it ever came off !!

It should perhaps be said that I only use this gadget if and when I can see there is a problem with the adhesive on the irrigation sleeve -- this happens in approximately 2% of the sleeves I use, so it's not very often, but it's useful to have an immediate solution close at hand when it does happen. 

Best wishes 

Bill