Bowel washout prior to a colonoscopy / reversal of stoma / fistula

Transcription

1 Patient information leaflet Bowel washout prior to a colonoscopy / reversal of stoma / fistula Clinical Sciences Building Stoma Care Team All Rights Reserved Document for issue as handout.

2 You have been asked to attend the hospital for a bowel washout. What is a bowel washout? A bowel washout is a way of clearing your large bowel prior to a procedure such as a colonoscopy. The bowel washout has usually been requested by your consultant and is carried out by the stoma specialist. Your loop ileostomy is situated at the end of your small bowel before it joins the large bowel. You have 2 opening in your stoma. The food you eat enters your mouth, passes down into the oesophagus (food pipe), through into the stomach, into the small bowel passing out of your body through your stoma. This is known as the functioning end. You also have a non-functioning end to your stoma that leads into your large bowel and down to your rectum. As the large bowel is recovering and not in use, mucus builds up and needs to be washed out. Small Bowel (ilieum) Anus Oesophagus Rectum Stomach Large Bowel (colon) 1

3 What is mucus? The lining of the bowel continuously produces a substance called mucus. This acts a lubricant for the passage of faeces. In a normally functioning bowel, you would not usually notice this as it is mixed with the stool. However, when you have a stoma, the mucus lies dormant in the bowel and most of it is not passed naturally. So why do I need a washout? If the doctor wants to look inside your large bowel with a camera, the mucus can stop the doctor from getting a clear picture. In some cases the mucus can prevent the camera from being passed into the bowel at all. Therefore it is important that your large bowel is clear and the mucus has been washed away before your have your colonoscopy. Other reasons I may need a washout? A build up of mucus in your bowel may cause you to have some discomfort in your stomach / abdomen. You may find that you have the sensation of needing to go to the toilet from your bottom and you do so at regular intervals Alternatively, you may get the sensation of needing to go to the toilet but are unable to pass anything. You could find that you feel you need to pass something but cannot. A washout could help with all of the above. Will the washout be painful? A bowel washout is not a painful procedure. You may experience some mild abdominal cramps and it can sometimes make you feel nauseous for a short time and occasionally you may vomit. If you do experience any pain, you must let your stoma nurse know immediately. The stoma nurse may ask to you to lie on the bed for a short time and give you some oxygen until you feel better. 2 3

4 What is involved in a bowel washout? How long does the procedure take? Can I eat and drink before my washout? The stoma nurse will begin by explaining the procedure to you. You will be asked to put on a hospital gown and remove your underwear. You will then be asked to lie on the bed on your left hand side with your knees bent up to your chest if you are able. The stoma nurse will pass a small catheter (tube) into your bottom and will slowly insert some saline (salt water) through the catheter. This will help to loosen any hard lumps of mucus in your rectum. When you feel your rectum is full you should sit on the toilet and pass the water and possibly some hard lumps of mucus from your bottom. You may have the urge to push and sometimes this can be uncomfortable. You will then be asked to remove your stoma bag while sat on the toilet. The stoma nurse will pass a small catheter into the non functioning end of your stoma. The stoma nurse will then slowly insert some saline through the catheter into your bowel. After a short time, you will begin to pass water and hard lumps of mucus into the toilet through your bottom. When the stoma nurse has finished, you may feel you need to take some time to sit on the toilet and let any remaining mucus pass. When you feel that this has stopped, you may replace your stoma bag and get dressed. This is the end of the bowel washout and you may go home when you feel comfortable. In the next day or two following the bowel washout, you may continue to pass lumps of mucus from your bottom. A bowel washout can take from 1-2 hours, sometime slightly longer until your stoma nurse is happy your large bowel is clear. You can go home immediately after your washout or as soon as you feel comfortable. Is the washout always a success? Although most of the time the washout is successful, occasionally there are times that a repeat washout is required or the washout doesn t solve your problem. What do I need to bring into hospital with me? All you need to bring with you is a spare stoma bag and the equipment you need to change it. You can eat and drink as normal before a washout. If you have any further questions regarding your procedure, please do not hesitate to contact us on:

5 G W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2018 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: SURG04(18) Review Date: October 2020 For further information on this leaflet, it s references and sources used, please contact Copies of this leaflet are available in other formats (for example, large print or easyread) upon request. Alternative formats may also be available via www. srft.nhs.uk/for-patients/patient-leaflets/ If you need this information leaflet translated, please telephone: In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities to access this service. Please contact the service/clinic you are attending by phone or prior to your appointment to discuss your requirements. Interpreters are available for both verbal and non-verbal (e.g. British Sign Language) languages, on request. Please contact the service/clinic you are visiting to request this. or InterpretationandTrans@srft.nhs.uk Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on This is a teaching hospital which plays an important role in the training of future doctors. The part patients play in this process is essential to make sure that we produce the right quality doctors for all of our futures. If at any time you would prefer not to have students present please inform the doctor or nurses and this will not affect your care in anyway. Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone If you would like to become a Foundation Trust Member please visit: for-members If you have any suggestions as to how this document could be improved in the future then please visit: for-patients