colonic irrigation
TRANSCRIPT
Colonic Irrigation Prepared by : Christian Raveina
Definition
• Colonic Irrigation or enteroclysis or bowel wash refers to the treatment of washing out the colon with large quantities of a solution in order to clear the colon of faeces
Purposes • To clean the colon of faeces , gas , excess mucus ,
barium etc .
• To dilute & remove any of the toxic agents that may be present in the large intestine
• To keep the individual clean in faecal incontinence and to check the diarrhoea
• To supply heat to the colon or to the pelvic & abdominal organs surrounding the large intestine to (to relieve pain & bring about circulatory changes in these organs )
Purposes
• To reduce temperature in hyperpyrexia & heat stroke
• To apply medications locally
• To supply the body with fluid & electrolytes that are absorbed from the intestine
• As a preparation for diagnostic examinations & certain surgeries to cleanse the bowel
Contraindications
• Loose sphincter
• Painful & bleeding hemorrhoids
• Fistula in anus
• Polyps & diverticulus of the intestines
• Rectal infections
• Painful skin lesions around the anus
• Massive carcinoma or tumors of the rectum
Solutions used
• Plain water
• Cold water
• Normal saline
• Sodium bi-carbonate solution 1 to 2 %
• Antiseptic solution such as silver nitrate 1 : 5000 ; potassium permanganate solutions 1 : 5000 ; thymol 1 : 100 ; alum 1 : 100 ; boric solution 1 to 2 % tannic acid 1 : 100 etc
• Amount of solution used :
•2 to 3 liter or till the return flow is clear
• Temperature of the solution :
•For cleansing purpose 104 ºF ( 40 º C )
•For thermal effect 110 to 115 ºF ( 43.3 to 46 ºC)
•For reducing temperature 80 to 90 ºF ( 27 to 32 ºC )
General Instruction • A cleansing enema should be given 1 hour before the
colon irrigation is started , so that the rectum will be free of faecal matter
• The bladder should be emptied before a colonic irrigation to reduce the intra-abdominal pressure
• The temperature of the solution be kept constant throughout the procedure
• Do not allow the air to enter into the intestine by :
• Expelling the air from the tube
• Not letting the fluid into to run in completely from the tube
• Make sure that the return flow is not blocked
• Stop the procedure temporarily if the client complaints of pain
• Use a smooth & flexible rectal tube & lubricate it well to prevent damage to the rectal mucosa
• Listen to the complaints of the client should not ignore any discomfort however small they may be
• Stop the treatment if the client shows the signs of fatigue & collapse
• Allow only 200 to 300 ml of fluid to run into the rectum at a time
• Then it should be drained out completely before introducing the fluid 2nd time
• Regulate the flow of fluid . Do not have the ingoing tube higher than 45 to 60 cm above the bed level & do not have the outgoing tube more than 30 cm below the bed
Methods used
By using
funnel
and catheter
By using
“Y” connector
and rectal tube
By using
2 tube method
By using funnel & catheter
Preparation of article
•Funnel & tubing with
glass connection
•Rectal tube placed in
a kidney tray
•Mackintosh & towel
•Water soluble jelly or
Vaseline
•Bucket
•Rag pieces in a
container
•hot & cold water
jug with prescribed
solution
•Paper bag
•Clean linen
•Parineal tray
Procedure
• Wash hands
• Prepare the solution at the required temp.Test the temp at the inner aspect of the wrist
• Attach the tubing & the rectal tube with the funnel , pour the solution in it & check for leakage
• Lubricate the tip of the rectal tube about 4 inches
• Fill the funnel with the solution & expel the air from the tubing by allowing a small amount of fluid into kidney tray. pinch the tube
• Separate the client’s buttocks to visualize the anus clearly & insert the tip about 4 inches , while the client exhales a deep breath
• Lower the funnel below the level of rectum
• Raise the funnel & allow the fluid into the funnel , before the funnel is empty
• When 200 to 300 ml of fluid has gone in , pinch the tube before the funnel is completely empty & invert it over the bucket & let the fluid drain
• When the return flow ceases turn the funnel upright & pour more solution
• Lower the funnel until the air from the tube has been expelled , then raise the funnel & repeat the procedure
• Continue the procedure until all the fluid ordered has been given or until the return flow is clear
• Temporarily stop the procedure ( do not remove the rectal tube ) if the client develops any discomfort
• Gently remove the rectal tube by pulling it through 3 to 4 layers of rag pieces
• Discard the rag piece in the paper bag. Place the funnel with the tubing in the kidney tray
• Turn the client ,assist him in a bed pan or commode
• Bring the parineal tray & give the parineal care
• Put on garments & change the linen if needed & make the client in comfortable position
• Wash hands
• Record & report the procedure
Using “2 tube” method
• In this method :
• An irrigation can with tubing
• Glass connection
• Screw clamp
• One rectal tube
• Catheter
• Attach the rubber tubing & catheter to enema can
• Fill the can with solution & expel the air ( this acts as the inflow tube & the rectal tube acts as the outflow tube )
• Mark the catheter about 6 inches from its tip & the rectal tube 4 inches from its tip
• Insert the tip of the catheter into the eye of the rectal tube & insert the tube together into the anal canal after lubricating them well
• When the tubes are in , pull the catheter slightly backward in order to dislodge it from the rectal tube
• Then insert the catheter alone until the marks on both tubes come together at the anus
• The preparation & after care of the client will be same as that of funnel method
• The fluid that flows from the enema can through the rectal catheter enters the rectum & return through the rectal tube which is situated 2 inches lower than the rectal catheter
Using “Y” Connection & Rectal Tube
• Articles will be same as that of 2 tube method
• A “Y” connection will permit the regulation of the inflow & outflow
• The tube for inflow is attached to one prong of the Y connection & the outflow tube is attached to the other prong
• The stem of the Y connection is attached to the rectal tube
• Clamps on the inflow & outflow tubes make it possible to direct the flow of fluid into the rectum & then out of the rectum
• The solution flows from the inflow tube through the rectal tube into the rectum
• When the clamp on the inflow tube is closed & the clamp on the outflow tube is opened , the fluid flows through the rectal tube to outflow tube & into the bucket
• By opening & closing the clamps alternatively , the fluid enters the rectum & return after washing out the rectum
Thank you…