My wife had bowel surgery at the Barbara Clinic in Hamm in 2013 and has been dependent on rectal irrigation ever since. The irrigation pump was prescribed there at the time.

We are very grateful for the possibility of bowle cleansing with a battery-operated pump. I have been advised often and very well by Mr. Schaefers and now by his daughter-in-law on the phone. The conversations have always been very helpful to me and my wife. They offer quick help by sending test samples or giving application instructions.

I am 23 years old and have been irrigating with the Irrimed since I was 6 years old. I came to this because I had a congenital anal atresia at birth, my bowel was too short. Although this could be corrected by an operation, i.e. I can also partially hold back my bowel movements. However, this would not be enough without irrigation. As a baby this was not a problem, nappies helped me like any other child. When it was time for me to get rid of the nappies, the first problems occurred. For a long time, my mother had to give me rectal enemas, suppositories or anal tampons.

When I was six, my doctor recommended that my parents get me an irrigation pump. At first my mother helped me, but I was soon able to irrigate on my own and was independent. Irrigation was a great relief for me. I no longer need suppositories or anything like that. I am able to clean my bowels in a controlled way and only with warm water. I now irrigate three to four times a week. I feel safer and am not afraid of uncontrolled bowel movements. This makes my life much easier and brings more quality of life. I no longer have to think about my incontinence and can concentrate on other things. The irrigation with irrimedb made it possible for me to travel long and far. I was able to travel to Australia, New Zealand and the UK without any problems. Without irrigation, this might not have been possible.

I have been irrigating with the irrimed since 2007, i.e. for 15 years. Because I had bowel cancer, I had to have an operation in 2007. An artificial anus had to be created because otherwise cancerous tissue could not be removed sufficiently. My stoma therapist later recommended irrimed to me. I was a policeman, am now a pensioner, and was able to carry out my duties as before thanks to irrigation with the irrimed.

I don't have any restrictions, except for the fact that as a man I am no longer allowed to lift heavy things.

I irrigate once a day and then put a cap on the stoma.

For stoma patients, irrigation is a special type of care. By letting body-wam water run into the intestine (similar to a conventional enema), the intestinal wall is stretched and the intestinal muscles are stimulated to act, which then leads to spontaneous bowel emptying. The more sections of the colon that are stimulated by the irrigation fluid, the better the emptying.

The stoma wearer who has lost natural control over bowel movements due to surgery is now able to influence the time of bowel movements and achieve safe stool-free periods from one to several days through irrigation alone.

Irrigation for colostomy has been used in the USA since the placement of stomas became a standard part of bowel surgery. Good experience with irrigation, which shows no side effects even after decades of use, makes it the ideal method of care for most colostomy patients in the USA.

It is hardly understandable that such a simple and low-risk procedure with such an excellent effect still finds relatively few users in Europe.

Essential advantages of irrigation:

• Long periods without bowel movements, so no bag supply is required, only ostomy caps or possibly mini pouches
• No bulging under tight clothing, as stoma caps, in contrast to pouch care, are not bulging.
• No or hardly any gas leakage and thus no odour or noise nuisance
• no skin problems due to excretions
• no problems during sports, swimming or in the sauna
• very low costs for the supply materials

Conclusion: Not only the high gain in quality of life, but also the great cost savings due to the low consumption of the very expensive supplies should be incentive enough for an affected person to prefer irrigation to pouching.

Report of a stoma patient

The following questions were answered by a stoma user whose standard of care since 1987 has been irrigation. It is a subjective assessment and can only be considered a rough guideline, as everyone feels differently. Before you start irrigating, ask professionals experienced in irrigation (stoma consultation in a clinic or similar).

Where can I learn irrigation?

The best place to learn irrigation is in a clinic or rehabilitation centre. There are usually experienced stoma therapists there who will be happy to show you how to irrigate, but the specialist staff in the specialised trade can also help you.

What is needed for irrigation?

You will need the Irrimed irrigator, Combifix irrigation tube bags, stoma caps or mini bags.

Should I irrigate standing up or sitting down?

Irrigation can be performed standing up or sitting down. The water inflow is better and faster when irrigating in a standing position than when irrigating in a sitting position.

When is the best time for irrigation?

The success of irrigation is all the better if it is carried out in accordance with the natural emptying habit of the bowel. The greatest readiness to empty is in the morning, about ½ to 1 hour after getting up.

What is the correct amount and temperature of water?

Many users often demand unnecessary precision for the water quantity and the water temperature. In the relevant literature, no exact values are given for either the water quantity or the water temperature. It is always a guideline value with a very wide range of variation.

I need about 2 litres of water for the irrigation, pre-rinsing with one litre and then using the rest for the main rinse. The optimal water temperature is about 37° C. Here, the Irrigator Irrimed provides valuable services, as it has an integrated temperature display.

The longer a person irrigates, the better they can decide how much water they need and at what temperature they will have the best success.

During my tests, I also noticed that at water temperatures below 30° C, emptying is not quite as spontaneous and good, however I did not notice any intestinal cramps, as often described, even at a water temperature of 22° C.

According to my observations, any cramps or intestinal pinching have a different cause:

Why do I have a pinching in the abdominal area?

In my experience, pinching or slight cramps in the abdominal area that sometimes occur during irrigation are not due to water that is too cold, to air bubbles in the water or to the water running in too quickly. The reason for this pinching is that the intestine works very hard and tries to push the water out together with some stool. If you stop the water supply, this pinching will immediately stop. You can also remove the cone from the stoma and let water and stool escape from the intestine for a short time. Then the irrigation is resumed.

How long do the enema periods last?

Water enema times should be in the range of 3 to 10 minutes. If the enema times are longer, too much water is absorbed by the intestine, resulting in a lower readiness for emptying. These enema times can be regulated very precisely with the Irrimed.

How often should you irrigate?

The purpose of irrigation is to achieve long stool-free periods. Therefore, it does not make sense to irrigate daily. But how can long stool-free periods be achieved?

During a conversation I have had with a stoma therapist, we also talked about this topic. At that time I was still irrigating daily. She gave me the tip to wait with the next irrigation until the bowel starts working by itself and then to irrigate. I tried this at a time when I was only near my house. In the course of time, I ended up with very long stool-free periods. Not everyone can achieve these long stool-free periods, but 48 hours are achievable for almost everyone with a little patience and practice.

The following list shows the days in April 1998 on which I irrigated.

How can you tell when to irrigate?

If you observe your body carefully, you will notice that after a certain period of time, more gas forms. This is often a sign that the time has come for an irrigation. If this increased gas formation occurs in the course of the afternoon without having eaten highly flatulent food, you should irrigate the next morning.

How much time does it take?

Once irrigation has become a routine for affected people, the time required is significantly reduced. Every stoma user has to find out after how long the bowel has emptied completely by observing his or her body. This varies from person to person. As a guideline for complete irrigation, you should reckon with a maximum of ¾ hour after the adjustment phase.

After what time do I achieve a stool-free period of 24 hours or more?

Success varies greatly from person to person. When I started irrigating and after about 14 days there was no noticeable success, i.e. the stool-free time was hardly longer than before, I switched back to bag supply. A few weeks later, I started irrigating again, as it sounded very tempting that the stool-free period for irrigating stoma carriers is 24 hours or longer. After about 6 weeks I started to see success. I didn't reach 24 hours yet, but it was a considerable amount of time that made the morning effort worthwhile.

Can I stop irrigating at any time?

Irrigation is not "obligatory", it can be stopped at any time without hesitation and replaced by bag supply.

What is the cost comparison between irrigation and bag supply?

The costs for the supply items for irrigation are about 1/3 lower than for bag supply. This could also be a reason for choosing irrigation.

Where can I get irrimed and Combifix?

You can obtain the articles like all your other stoma articles from specialist retailers on prescription.