Home

How do you control bowel movements after an ileostomy reversal

Crazy/Frequent Bowel movements after ileostomy reversal I just recently had a temporary ileostomy reversal and have 10-20 bowel movements in a day and was wondering how did people control the same.I am taking metamucil twice a day and imodium as needed but does not seem to help much. My surgery was done 3 weeks back and was diagnosed with stage 2 rectal cancer and had chemo/radiation before. When you have the urge to have a bowel movement, use deep breathing and sphincter tightening (Kegel exercises). Kegel Exercises - Tighten your anal muscle or sphincter as if you are trying to prevent a bowel movement. Hold for a count of 10 while squeezing tightly. Then relax for a count of 10 When frequent bowel movements occur, drink less fluid with your meals, drink more fluids between meals and avoid hot beverages. Increasing the amount of starches and constipating foods in your diet will help thicken stool and slow bowel actions. These foods include: Pasta Crackers Bananas

Crazy/Frequent Bowel movements after ileostomy reversal

  1. Hi Lynn, I'm six weeks post ileostomy and had the same thing today, but they were much more than the small amounts of mucus I passed in the days following the surgery. Just clear mucus but about the amount of a small bowel movement. I see my GI tomorrow morning and plan to inquire with him
  2. Insert drain: Ileostomy after rectal cancer is used to protect the rectal resuturing to establish continuity in the bowel. II there is some kind of abscess and leakage it can occur where the ileostomy has been reversed or at the site of the rectal suture line which may not have been ready for closure
  3. For some patients, interrupting bowel function with a temporary ileostomy increases the chances that you will experience alterations in bowel function after reversal of your stoma. These symptoms can include rectal urgency, frequency, fragmentation of stool and incontinence
  4. How frequently will I have bowel movements after an iteostomy reversal How many bowel movement after ileostomy reversal reversal of ileostomy Diet following ileostomy reversal ileostomy reversal surgery colostomy reversal Pregnant after Ileostomy Reversal Bowels after ileostomy reversal, I am on loperamide daily very bad anal itching after.
  5. A doctor may recommend pelvic floor physical therapy. This therapy can help re-train the pelvic floor muscles to have a bowel movement. However, most surgeons will recommend waiting until at least..
  6. How do you control bowel movements after an ileostomy reversal? Spicy foods and raw vegetables may burn or irritate the skin around your anal opening. Foods that improve stool thickness help prevent leakage and frequency

Ileostomy - Diarrhea After Reversal - April 2019 - Ostomy

Exercise can help with the management of constipation as it helps to stimulate the bowels normal wave like movement. It is advised not to undertake strenuous activity within the first few weeks following your reversal operation. Gradually introduce any physical activity previously performed and increase slowly. Resume sexual activity as you feel able. It is best to avoid swimming until your wound has healed, this will help avoid the risk of wound infection Reconnecting the small intestine to the rectum restores the ability to have bowel movements without an ileostomy bag. Before excision, the colon collected and stored stool until passing it from the body. The small intestine, although altered by surgeons for this purpose, adapts, but never fully attains the ability to do this quite as well For the majority of people, a doctor will recommend hospital discharge within three to five days after undergoing ileostomy reversal surgery. Don't worry if you have to go to the toilet more often than usual due to diarrhea. A normal part of the recovery process, this may go on for several weeks If you are having several bowel movements in a day, you may need a bland diet. You may need to eat white rice, bananas, and apple sauce. Avoid spicy and greasy foods. You may need to avoid dairy foods, such as milk and cheese I had an ileostomy after surgery for rectal cancer in March 2012. After chemo, lots of test and an NHS wait, I had my reversal on 31st May this year. I was looking forward to being a member of the 'Dyson' club, but also apprehensive as I had heard a lot of horror stories about how long the bowel would take to settle etc

Bowels after reversal - Ostomy - Inspir

  1. A stoma reversal is surgery to attach your bowel together after a colostomy or ileostomy (also called ostomies). During ostomy surgery, the bowel was separated and attached to an opening made in the skin of your belly. The opening is called a stoma. Stool passes through the stoma and out of your body. Ostomy surgery can be permanent or temporary
  2. You may have a sore bottom after the reversal, but this should improve as you get used to passing stools through your anus again. After every bowel movement, it may help if you: Wash the skin around your anus with warm water. Pat it dry with a soft cloth
  3. Diet After Surgery/Ileostomy Reversal. I'd be really interested to hear other people's experiences with food after surgery and after ileostomy reversal. It's been 6 weeks since my reversal, which happened a lot quicker than expected as my small bowel was damaged. Luckily my rectum was completely healed (removed tumour from rectum and pretty.
  4. About your ileostomy closure surgery. An ileostomy closure surgery is done to reverse your ileostomy so you can have bowel movements like you did before your surgery. Ileostomy closure surgery is usually done through your stoma (see Figure 1). Your surgeon may need to make an additional incision (surgical cut), but this is rare

You may also experience a sore anus after the reversal operation. This should improve as the anus becomes used to having stools pass through it again, although common barrier creams can help. The reversal operation is usually a smaller procedure than the initial ileostomy procedure, but it still takes several weeks to fully recover

Bowel movement after illeostomy - Ostomy - Inspir

This booklet is designed to tell you about your reversal of ileostomy operation At the end of the operation the surgeon will put your bowel (ileostomy) back control the pain. Bleeding: during or after surgery. Rarely, a blood transfusion may be needed What are the risks of ileostomy reversal surgery? You may bleed more than expected. You may get an infection. You may become dehydrated. You may bleed from where your ileum is stitched or stapled. After surgery, bowel contents may leak into your abdomen and cause an infection. You may also get an infection or abscess where your stoma was closed Some people who have a colostomy or ileostomy to remove stool from their body will live with it for life. Others may have a temporary ostomy while they recover from surgery.. Or you may be eager. How do you control bowel movements after an ileostomy reversal? Regaining bowel control after a stoma reversal. Diet - you may find it easier to eat small, low fibre meals and gradually increase quantity and variety over time. Protect your skin - you may find it easier to use unfragranced wet wipes to clean up after each bowel movement reversal. I had all of my rectum removed and a temp. ileostomy. I then had the reversal 5 weeks later. I did not do well after the reversal surgery and spent the next 18 mos. in the bathroom or looking for one. It was awful. I then made the hardest decision in my life and had a colostomy done. That was in 1/05

In the first four weeks following ileostomy reversal, it is important to chew food carefully, eat slowly and consume smaller meals five or six times a days, according to MSK. Eliminate heavy lifting and exercise, to prevent a hernia of the bowel. Clean the anus with warm soapy water, and use wipes and creams as necessary ileostomy and bowel movements Hi all, I'm new today. I found this forum through google and I read stories that gave exact information I was looking for. Thanks. (I'll be looking further into post ileostomy reversal chats a lot more). My question now is that I've had a few bms while I still have my stoma. The first time, the doc said it was totally normal and nothing to worry about Well, a good dr will do a sitz marker test (or 'transit study' - i dont think you need any other test seeing as this is a new situ for you) which you take do to see how your bowel is performing. They xray you after four days or so to see where the markers are in your bowel. you must not take laxatives during this process extremely hard to predict how your bowel will work following your reversal. It can take anytime from 6 weeks up to a year for your bowel to settle into a new routine. How will my bowel work following reversal? Your bowel function will usually be erratic following your reversal. Your bowels should usually start to work 2-3 days after your operation

How long after ileostomy reversal to expect normal bowel

Constipation after Ileostomy Reversal. My colon perforated last May. I had 28 inches of it removed and had a temporary ileostomy that was reversed in July. I was told to expect frequent bowel movements and diarrhea. I have had quite the opposite. I take the maximum dose of Zelnorm daily plus daily stool softeners, however I remain constipated When you do ileostomy reversal you will need a new diet plan. First and most important thing is not to have large meals. Your body won't tolerate this and you will have problems with bowel movements. The best option is to eat every three hours but smaller portions. You will need a lot of proteins Welcome to MeetAnOstoMate.org. I'm writing here because I don't know where else to look for answers and support. My husband had a colostomy back in June of this year. After 20 years of severe chronic constipation his colon gave up and had to have part of it removed. In September, about 2 weeks ago he had a reversal After colostomy surgery, stool may look different than it did prior to surgery, but should tend to still be fairly formed. People with a colostomy will not have control over when a bowel movement takes place from the stoma. The ostomy appliance might need to be emptied a few to several times a day

An ileostomy bypasses the anus, rectum and colon and does not have as many complications as a colostomy has.. This type of surgery is performed because of conditions such as an inflammatory bowel disease causing a bowel obstruction, diverticulitis, cancer, or trauma.It is important to mention that these surgeries affect the small and large intestine Both a colostomy reversal and an ileostomy reversal are performed in the same manner. Also Know, is a stoma reversal painful? It's common to have problems with how the bowel works after a stoma reversal. You may have symptoms such as loose stool, incontinence, sudden bowel urges, and pain. Other risks include infection in the belly and blockage. Bowel movements are not as frequent any more and the pain has subsided so much! Booty still hurts occasionally, I can't sit for long periods of time cause it starts to ache. I still get the dumping syndrome but not near as often, maybe 2 times a month. It has now been 7 months since my reversal and 18 months since my LAR surgery Also, you have to do the exercises every day or it doesn't work, Dr. Irani notes. Pads that you tuck into your underwear or adult diapers can offer security when you have fecal incontinence. But pads and diapers can irritate the skin, as can a bowel movement that's been near your skin for too long

Facts About Ostomy Reversals United Ostomy Associations

However, reversal surgery is not something that you should be rushing. For the reversal to function appropriately, the anal and bowel muscles must be working well. According to experts, a complete colostomy recovery takes at least six to eight weeks. But in some cases, the healing process can take up to a year Below are a few things that have helped me after stage 3 colorectal treatment which included chemo, radiation, complete resection of entire rectum, ileostomy bag for 6 months, ileostomy reversal. For almost 3 years after ileostomy reversal, I had fecal incontinence 20-30 times per day (plus flatulence incontinence so I had to resign from my job)

ET1980. I am an ET nurse and yes it can be normal to have a BM through your anus if you have a Loop colostomy or Loop ileosotomy. This means that the ostomy is temporary in most cases and there will be a reversal where the loop of bowel is sewn up and placed back in the abdomen. Duzluvxist Re: Ileostomy reversal after rectal cancer op. I had my illeostomy reversed in July 2010 after 5 years. I've had all of the usual problems of frequent BM's, diarrhea and burning. Like most others I've been taking Loperamide (Immodium) with some limited success, but seem to lurch between constipation and loose BMs The procedure is the reversal of a colostomy, the creation of an artificial opening in the abdomen to eliminate solid waste when the body cannot do it naturally. The surgery itself it a relatively simple procedure. For some patients, the adjustment period after surgery may be difficult and, in some cases, painful. Complications are a possibility The bowel and anal sphincters should also be strong enough to manage bowel movements following the reversal. In general, patients should wait three to 12 months before a reversal can be done. If the colostomy was performed to remove cancer, patients will need to complete treatment prior to a colon reattachment

What to expect post ileostomy reversal? Intestinal

What do you suggest if my dad has a loop colostomy, and is hoping to reverse it. how easy or hard is the reversal procedure? Dr. Myron Arlen answered Surgical Oncology 64 years experienc Colostomy. Colostomy. In some cases, after the surgeon removes a portion of the colon, it may be necessary to attach the remaining colon to the outside of the body in a procedure called colostomy. Creating a hole (stoma) in the abdominal wall allows waste to leave the body. A colostomy bag attaches to the stoma to collect the waste Aims and objective: To illuminate what it means to live with a resected rectum due to rectal cancer, after reversal of a temporary loop ileostomy. Background: Today, treatment for rectal cancer is performed with increasing emphasis on sphincter-saving surgery, meaning that an anterior resection often includes construction of a temporary loop ileostomy that is later reversed

Ileostomy reversal: Timing, success, risks, diet, and mor

You may also plan your sexual activity for times when you're less likely to have a bowel movement. Some people with a permanent colostomy, irrigate (give themselves an enema through the stoma) to try to control their bowel movements. For more information about irrigation, see the section titled Frequently Asked Questions About Ostomy Care Ileostomy - discharge. You had an injury or disease in your digestive system and needed an operation called an ileostomy. The operation changed the way your body gets rid of waste (feces). Now you have an opening called a stoma in your belly. Waste will pass through the stoma into a pouch that collects it Stool passes from the colon to the rectum. The rectum measures 6 to 8 inches in adults and is located between the last part of the colon and the anus. The rectum stores stool prior to a bowel movement. During a bowel movement, stool moves from the rectum, through the anus, and out of the body. Why does a person need ostomy surgery of the bowel If you have a large intestine problem that can't be treated with medications, you might need an ileostomy. One of the most common reasons for an ileostomy is inflammatory bowel disease (IBD).The. 2. Medications can help control your bowel movements. zOver the counter anti-diarrheal medication, such as Loperamide (Imodium, Kirkland Anti-diarrheal, or other pharmacy brands) can be helpful for some to stop frequent bowel movements. It can be taken after a cluster of bowel movements to end them so you can go out, or sleep without interruption

What can I eat after ileostomy reversal

Since the ileostomy has no sphincter muscles, you will not be able to control your bowel movement (when stool comes out).You will need to wear a pouch to collect the stool.The stool coming out of the stoma is a liquid to pasty consistency.. Read, more on it here. In this regard, what does stool look like from an ileostomy? Your stoma is made from the lining of your intestine Here you will find helpful information and advice on looking after your stoma including skincare, travel, irrigation, surgery and the different types of stoma. The Bladder & Bowel Home Delivery Service can offer you expert advice from a trained nurse about stoma care and help you find the right products to manage your condition A colostomy or an ileostomy can be temporary or permanent. The doctor may do a temporary colostomy or ileostomy to allow the intestine to rest and heal after surgery. It will be permanent if the anal sphincter and the lower part of the rectum are removed. A colostomy or an ileostomy may also be called a bowel diversion An ileostomy is a surgically made opening on the skin of the belly where the small bowel (small intestine) called the ileum is brought to the surface of your abdomen to form the stoma (the opening). An ileostomy replaces the rectum as the place where waste of the digestive system (stool) leaves your body. An ileostomy is typically made in cases.

Reversal of your ileostomy or colostomy (stoma closure) so that loss of control of your . 10/01/13 3 bowels (or faecal incontinence) will not develop as a result. The surgeon is likely to Frequency and urgency - It is normal to have erratic bowel movements for several weeks after this operation. You may find that you need to go to the. stool and generate a bowel movement. To have the reverse affect it is important for patients post bowel resection to take their fiber supplement with little or no additional water. To do this start the process by taking one teaspoon of Metamucil and mix it into a food substance. Ideal foods are oatmeal, yogurt, pudding, a mashed banana, applesauce Stoma reversal operations. Surgery to reverse a temporary colostomy or ileostomy (reconnection of the bowel) can be is a relatively minor procedure, but not all colostomies or ileostomies can be reversed. Deciding when to do the reversal depends on a number of factors including how well the patient has healed after their initial surgery and how.

bowel movement after 4 to 5 days. However, if this does not happen you should not be too worried. Bowel movements are different from one person to another. Usually, the first sign that your bowel is beginning to work is when you pass wind. You may then find that your bowel habits become unpredictable, with a sense of urgency Then, with some simple adjustments, you can hopefully gain control of producing more regular bowel movements. Here are a few of the more common causes of diarrhea with an ileostomy or colostomy: Diet. The consistency of your stoma's output can be drastically changed by the foods and beverages you consume Crazy/Frequent Bowel movements after ileostomy reversal . Whatnext.com DA: 16 PA: 50 MOZ Rank: 66. Crazy/Frequent Bowel movements after ileostomy reversal I just recently had a temporary ileostomy reversal and have 10-20 bowel movements in a day and was wondering how did people control the same.I am taking metamucil twice a day and imodium as needed but does not seem to help muc Note: After abdominal surgery, a blockage of the small bowel can happen for many reasons including from scar tissue (adhesions). If stool is not coming out of your stoma, it is best to call your doctor or go to the emergency room (ER) immediately to determine if you have a stoma blockage related to food, or a small bowel obstruction.

After you are discharged from the hospital, you will take Imodiumor Lomotil or a fiber supplement such as Metamucil, to control your number of bowel movements. Metamucil and other bulk laxatives act by absorbing excess fluid in the stool. Do not take any extra fluid with Metamucil, despite the directions on the bottle How do bowel movements work after an ileostomy is placed? the patient has no voluntary control of bowel movements. The stoma of an ileostomy is typically located where? in the right lower quadrant. What is a restorative proctocolectomy with IPAA Products for faecal incontinence can enable people with bowel leakage to lead a normal public life 1 2.Some products are intended to prevent bowel leakage (such as anal plugs and inserts), while others contain the leakage (such as pads and faecal collection devices)

4 Common Symptoms After Ileostomy Reversal Surgery

After his initial repulsion and fear, Matt began learning about his ileostomy bag with the help of Erin Testerman, the colorectal division's certified wound, ostomy, and continence nurse. With her support, Matt says he became a pro at caring for - and living with - his ostomy An ileostomy closure is a procedure that disconnects the small intestine from the large intestine. There are various things you should know about caring for your ileostomy closure. The area will likely be swollen for several days after the initial operation, and infection may be prone to occur Fecal incontinence, also called a bowel control problem, is the accidental passing of solid or liquid stool or mucus from the rectum. Fecal incontinence includes the inability to hold a bowel movement until reaching a toilet as well as passing stool into one's underwear without being aware of it happening

ileostomy bag 6-8 times per day when it is half full. • Jejunostomy output is often much higher volume and more watery. Patients with a jejunos-tomy may require intravenous (IV) nutrition support. • Colostomy output is more like regular bowel movements and typically does not require dietary or fluid adjustments the small bowel. How-ever, if gas is a problem, patients may need to avoid activities that increase the amount of swallowed air, such as smoking, chewing gum, drinking through a straw (3), or consuming carbon-ated beverages. Salt intake should be liberal-ized due to higher sodium losses in ileostomy output. People with ostomie Hello and Welcome to 'Ask A Doctor' service. I have reviewed your query and here is my advice. Rectal burning after reversal of ileostomy is a well-known thing as the food does not get sufficient time for proper digestion and stays in the intestines; hence the stool will have all the components like pancreatic enzymes, bile and so on. I would advise you the following in such a situation The anus can become sore after reversal until the body acclimates to regular bowel movements. It may take 10 to 20 visits daily to the bathroom after a colostomy reversal before the patient returns to regular bowel movements, according to ColostomyCare.org. Diarrhea and/or constipation are typical side effects of the surgery and can take months. An ileostomy normally becomes swollen when there's a blockage and you probably won't be able to see much movement of your stoma because the blockage will be stopping that but it should all return to normal after the blockage has passed

What to expect when recovering from ileostomy reversal surger

01:18 the bowel are reattached waste is now able to pass through the small intestine. 01:24 collect in the pouch and out through the anus after the surgery is complete your. 01:30 body will need time to adapt to the pouch some patients may experience an. 01:35 increased number of bowel movements but this will typically decrease after som you brush your teeth, your stoma may also bleed slightly. However, if your stool is bloody, or you have constant bleeding, you should contact your doctor. Since the ileostomy has no sphincter muscles, you will not be able to control your bowel movement (when stool comes out). You will need to wear a pouch to collect the stool About 20 inches were removed and a colostomy was performed. After three months I had successful reversal surgery. However, I have had abdominal pain and pressure and difficult bowel movements since then with the situation getting progressively worse. About a year ago I had a colonoscopy and endoscopy reversal of ileostomy How frequently will I have bowel movements after an iteostomy reversal colostomy bag - can't imagine Ostomy reversal after having a perforated colon due to diverticulits After Colon Surgery Can someone tell me more about ilium? Reversal of ileostomy and Crohn's info about illeus diverticulitis treatment Intestinal.

I have come to terms with the fact that I will never function like I did before. I where sanitary pads most days , just in case. You will regrain more bowel control as time goes on but I have yet to hear from anyone who did not have to face some problems after reversal. We are alive and well, for me that is the important thing Crazy/Frequent Bowel movements after ileostomy reversal . Whatnext.com DA: 16 PA: 50 MOZ Rank: 74. Crazy/Frequent Bowel movements after ileostomy reversal I just recently had a temporary ileostomy reversal and have 10-20 bowel movements in a day and was wondering how did people control the same.I am taking metamucil twice a day and imodium as needed but does not seem to help muc voluntary control over bowel movements is lost. promote skin integrity provide emotional support. when training bowel movements, when should you assist the patient in getting to the commode or onto the bedpan. when patient arises each day after each meal created for an ileostomy to help control the effluent. Kock pouch through your stoma). Some people with colostomies routinely regulate their bowel movements in this way. During your first irrigation, you may feel faint, hot, or sick (vasovagal syncope). Therefore, you are recommended to do it with your health care provider or an informed person in attendance in case you need assistance You may know that nausea and vomiting can be a common side effect of surgery. However, acute or chronic diarrhea can sometimes happen, too. Acute diarrhea usually goes away after a day or two.

Ileostomy Reversal (Ambulatory Care) - What You Need to Kno

After getting the ileostomy reversed I have, went back to a reasonable normality in leaps and bounds because the colostomy and the state of the stuff that comes out into the colostomy bag is a lot like your normal faeces when you go to the toilet to sit down and have a bowel movement. And although you don't have the same control the consistency. Small bowel resection is surgery to remove a part of your small bowel. It is done when part of your small bowel is blocked or diseased. The small bowel is also called the small intestine. Most digestion (breaking down and absorbing nutrients) of the food you eat takes place in the small intestine. The small intestine absorbs much of the liquid. Bowel surgery, colostomy and ileostomy. Removing a section of the bowel, normally to treat cancer. Enquiry online. 0800 169 1777. Surgery may be necessary to treat bowel cancer. Your bowel is a long tube and the surgery usually involves removing the section of the tube affected by cancer. The amount of bowel removed depends on the position and. People who have an ileostomy formed but have an intact large intestine may also experience discharge from their rectum. The longer the remaining section of your bowel is after stoma surgery, the more likely you are to have rectal discharge. Mucus can vary in appearance, for some it can be a clear egg white to a sticky, glue-like consistency In our society, bathroom needs are kept private. Talking about stool and bowel movements can be awkward or uncomfortable. This is often true for a person with an ileostomy. But while you learn how to deal with the changes that have been made, you may need help and advice

There is no such thing as an ileostomy diet. An ileostomy is not a sickness, so there is usually no health reason for not eating the foods you ate in the past. If you have a special diet because of heart disease, diabetes, or other health problems, you should ask your doctor about a diet that will work with both the problem and your ileostomy A stoma is part of either the large or small intestine that diverts stool or urine into an external pouch. The diameter and width of a stoma can depend on what type of ostomy a person has. The color of the stoma is red, and the surface is wet. You can see an image of my stoma in this Shield HealthCare article

Purpose Surgery is often needed to treat certain conditions of the colon (large bowel). Sometimes the surgeon must make an opening on the abdominal wall through which intestinal waste (feces) can pass. This surgery is medically known as colostomy and ileostomy. The opening itself is called a stoma. A lightweight, disposable bag is then worn over the stoma Bowel surgery, colostomy and ileostomy at Spire Parkway Hospital. Removing a section of the bowel, normally to treat cancer. Enquiry online. 0121 704 1451. Surgery may be necessary to treat bowel cancer. Your bowel is a long tube and the surgery usually involves removing the section of the tube affected by cancer

A stoma reversal is surgery to attach your bowel together after a colostomy or ileostomy (also called ostomies). A stoma reversal can be done if there is a large enough section of healthy bowel left to be rejoined. A temporary ostomy may be used for certain health problems dose that will control you bowels without constipating you. The more you take the thicker your stool should become. If you do not take enough your stool will remain watery. It is usual to start on a low dose and build It up slowly over a few days so you can judge how your bady is responding. Loperamide comes in capsules and tablets or as a syrup For people with a colostomy, a blockage could happen over several days and may start with signs of constipation. For people with an ileostomy, a blockage can happen quickly in less than 24 hours. An ileostomy is generally quite active, with people usually draining their stoma appliance between five to seven times in a 24-hour period

Total colectomy or proctocolectomy - discharge. You had surgery to remove your large intestine. Your anus and rectum also may have been removed. You also may have had an ileostomy. This article describes what to expect after surgery and how to take care of yourself at home 4. Stay Active. Your ileostomy doesn't have to slow you down. If you're a runner, keep running. If you love spin classes, keep spinning. If you enjoy skiing, walking, lifting, dancing, hiking. Having an ileostomy will be a significant change in a person's life. A person may experience fewer symptoms associated with bowel damage, but an ileostomy requires regular care People with colostomies may choose colostomy irrigation to regulate bowel movements and cleanse the bowel. The process involves flushing the colon daily with water through a stoma (surgical opening) in the abdomen. You don't need to wear a colostomy bag. People with inflammatory bowel disease or colon cancer may need a colostomy and irrigation