Laparoscopic Total Colectomy & Ileoanal Pullthrough
Pouch Irrigation
These are started 4-6 weeks before your final surgery for ileostomy closure. The purpose is to slowly increase the volume of water that the "pouch" can hold. It helps strengthen the ability of the anal sphincter muscles to hold stool or gas and helps your pelvic muscles "learn" the sensation of fullness of the ileal pouch. Your surgeon and/or outpatient nurse practitioner will give you detailed instructions when to begin these fluid "challenges" and how much water to instill.
The Pouch Irrigation Procedure
- A catheter is lubricated and placed into the anus.
- Water is drawn up in a large syringe and instilled into the pouch -- usually beginning with 1 ounce of water one time per day. Remove the catheter. Try to hold the water in for as long as possible (15 minutes to 1 hour) then empty it out by sitting on the toilet.
Each week increase the amount by 1 ounce:
| Week | Ounces | Time |
|---|---|---|
| Week 1 | 1 ounce total | hold for 5-10 minutes |
| Week 2 | 2 ounces total | hold for 10-15 minutes |
| Week 3 | 3 ounces total | hold for 15-20 minutes |
| Week 4 | 4 ounces total | hold for 20-25 minutes |
| Week 5 | 5 ounces total | hold for 30-35 minutes |
| Week 6 | 6 ounces total | hold for 35-40 minutes |
