IryPump S Colostomy User Guide Oct 2014

Contents General information on colostomy irrigation

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What does irrigation do?

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When can the irrigation method start to be used?

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Where does the water flow go and what does it do?

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Is irrigation suitable for me?

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Contraindications

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Irrigation with IryPump® S

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The procedure step by step

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Products for colostomy irrigation from the B. Braun range

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FAQs

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General information on colostomy irrigation Modern medical care products which are gentle on the skin provide colostomates with a high degree of safety and comfort. However, the lack of control over stool discharge and gas emissions, as well as the associated aesthetic and psychological factors, continue to represent a great burden for many patients. The method of flushing the intestine, also called irrigation, is recommended for colostomates in order to facilitate control over stool discharge. This makes it possible for such patients to reduce their usual care needs to a minimum and also benefit from considerably better comfort, discretion and quality of life, not to mention maximum independence.

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What does irrigation do? The aim of the irrigation is to stimulate the intestine to increase the movement of its contents (called peristalsis) by rinsing it regularly. This happens due to a tissue stretch stimulus triggered by the flow of water.

Such irrigation does not replace the functions of the intestine, but rather enhances the natural ability of the colon to empty itself. There is no decrease in effect over time as generally occurs, for example, with the regular and long-term use of laxatives.

The enhanced movement of intestinal contents results in a complete evacuation of the colon at the desired time, and thus the patient can then enjoy up to 48 hours with no evacuation. The length of this period depends, amongst other factors, on the length of intestine which remains, as well as on your dietary habits.

Sticking to a regular schedule is a critical factor in the success of the irrigation method.

In addition, this flushing of the intestine can reduce the amount of gas producing bacteria in the intestine, resulting in a significant reduction in flatulence. 4

When can the irrigation method start to be used? From a medical point of view, the irrigation method can start to be used around three months after your operation. Before starting on colostomy irrigation you should become familiar with how to use a conventional stoma bag. Colostomy irrigation is ideally carried out in your toilet at home.

A regular routine The time for performing irrigation should be adapted to suit your lifestyle and become part of your daily routine. This will vary from individual to individual. The important thing is to irrigate at the same time every day or every other day. To begin with the irrigation process may take upto 60 minutes from start to finish. However, as you get more familiar and comfortable with the process, this time can reduce to between 30 and 45 minutes.

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Where does the water flow go and what does it do? The water flows in through the stoma 7, through the various sections of the colon 5, 4, 3 and on to the cecum 2 (depending on volume of water and flow rate). The water cannot penetrate the small intestine, because a natural ‘valve’ prevents it. The incoming water encourages your bowel to start moving the colon contents towards your stoma.

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The volume of water needed for irrigation varies from person to person. Your nurse will consult with you to determine the volume of water needed.

Small intestine

2

Cecum with appendix

3

Ascending colon

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Transverse colon

5

Descending colon

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Sigmoid colon

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Colostomy

5

4

3

1

7

1

6 2

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Is irrigation suitable for me? Irrigation must always be first discussed with your health-care professional e.g. Stoma Nurse and all possible risks taken into account. Irrigation should proceed under the guidance of appropriately trained practitioners. Once you become familiar with the equipment and procedure of irrigation, then it can be done easily without supervision. Irrigation is indicated for colostomates with a sufficient length of colon remaining. Your stoma care nurse will be able to advice if you are a suitable candidate for irrigation.

General conditions n

An end colostomy - located at the end of the descending or the sigmoid colon

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A normal bowel function exists with regular, formed stools

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The user is familiar with the handling of normal stoma appliances

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The patient has a regular routine in which to perform irrigation

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Contraindications n

Colon prolapse

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Hernia

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Anatomic anomaly of the colon

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Inflammatory bowel disease e.g. Crohn‘s disease/Colitis ulcerosa

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Colon stenosis

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Radiotherapy and chemotherapy during treatment

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Poor health conditions

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Cardiovascular disease

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Operation in the abdominal area or the rectum during the past 3 months

Caution You should seek advice from your health-care professional if you are taking steroids and/ or anticoagulation medication.

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Irrigation with IryPump® S The IryPump® S is the latest development from B. Braun in the field of electrical irrigation systems and sets completely new standards in irrigation therapy in terms of design, function and handling.

Simple to use, adjustable to individual needs, surprisingly compact and totally portable thanks to the integrated high performance battery the IryPump® S will help you to achieve maximum comfort, discretion, quality of life and independence.

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The procedure step by step All the equipment needed for irrigation (IryPump® S, pouch, irrigation sleeve, face plate, etc.) should be laid out prior to starting irrigation. Check that the battery in the IryPump® S is fully charged. Important: for safety reasons, irrigation with the IryPump® S is only to be carried out when operated by battery, not when still connected to the mains.

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When using an electrical irrigation pump whilst travelling abroad, you may need an adapter for the power source. You may also need an information leaflet for customs when travelling by air. Further information can be obtained from the manufacturer. In countries with poor water quality, it is recommended to use shop bought still bottled water instead of tap water.

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Turn on the IryPump® S to check if the battery is properly charged. n

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Ring lights up green ››› the IryPump® S is charged and irrigation can begin. Ring lights up red ››› the IryPump® S must be charged before the next irrigation can be performed.

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If the ring starts to blink during the course of irrigation, it will still be possible to complete the irrigation procedure which has already begun.

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The control dial of the IryPump® S will slowly blink green, while charging.

Remove the water container from the pump module by pressing the side release tab.

Extend the water container, to do so just pull the inner section up until it audibly clicks into position (first right side, then left side).

Fill the water container with the prescribed amount of water.

Attach the filled water container back onto the pump module.

Check that the water is at the correct temperature (36 to 38°C). The temperature indicator is located at the bottom of the water container.

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Use the quick connector to fasten the tubing system onto the pump.

Connect the other end of the tubing system to the cone.

Expel all air from the tubing system by turning on the IryPump® S and setting it to flush level 3. When the tubing system is completely full with water and no more air can be seen in the tubes, turn off the IryPump® S.

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tip! tip! Remove your stoma pouch.

There are 3 different options:

Take an IrySleeve® irrigation sleeve and attach it to your stoma.

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The irrigation sleeve can be attached to the skin directly.

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The irrigation sleeve can be attached to the irrigation face plate.

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The irrigation sleeve can be attached to the two-part Softima® Key base plate with a 60 mm lock ring.

Let the lower end of the irrigation sleeve hang over the toilet. Fix it in place on the belt using the integrated coupling system if required.

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Lubricate the cone with a water based lubricant before insertion.

If the water does not flow into the intestine, reinsert the cone.

Carefully guide the cone into your stoma through the upper opening in the irrigation sleeve.

In some cases a pre-rinse procedure using approx. 150 – 200 ml of water prior to the actual irrigation process is advisable in order to achieve a more effective result.

Start the IryPump® S at the flow rate recommended by your stoma nurse.

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When all the water has poured into the intestine, turn off the IryPump® S again. Wait about 2 or 3 minutes before removing the cone from your stoma. The evacuation process should last approximately 45 minutes.

Fold up the sleeve.

The 2 sleeve edges should be side by side.

Start closing the sleeve by rolling back the clamp.

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The clamp should be rolled three times.

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Then, close the sleeve by pressing the clamp edges.

Make sure the clamp is in place.

Once the evacuation starts, reopen the sleeve and hang it over the toilet.

When irrigation is complete, dispose of the irrigation sleeve with your household waste. Remove the face plate if there is one, clean your stoma and apply a suitable stoma cap to stay in place until the next irrigation is scheduled.

Clean your irrigation system with warm soapy water, then dry it. Recharge the battery of the IryPump® S, if needed, to be ready for the next irrigation.

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Products for colostomy irrigation from the B. Braun range

IryPump® S | Colostomy irrigation

2 3 4 5

2 1 6 8 7

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