whole bowel irrigation

1. WHOLE BOWEL
IRRIGATION

2. WHAT IS WHOLE
BOWEL
IRRIGATION?
 Medical process involving the rapid
administration of large volumes of
an osmotically balanced
polythelyen glycol solution (
Golytely,Colyte) ,either orally or via
nasogastric tube ,to flush out entire
gastrointestinal tract.

3. PURPOSE:
 To prepare for diagnostic examination or before
certain surgery
 To relieve inflammation
 To stimulate peristalsis
 To supply fluid and electrolyte those are absorbed
from intestine
 To dilute and remove toxic agents
 To reduce temperature in hyperpyrexia
 To relieve fecal incontinence
 To supply medications locally
 To clean the colon of feces, gas and barium
 To treat infection and other pathological
condition of colon

4. PREPARATION OF
THE PATIENT &
ENVIRONMENT
 Explain the sequence of the procedure
 Arrange the articles at the bed side
 Provide privacy
 Place the Mackintosh and towel under
the patient
 Place the patient in left later position
 Keep the bucket on a low stool or receive
the out flow of fluid
 Remove the back rest and extra pillows

6. EQUIPMENTS
 Funnel and tubing with glass connection
 Mackintosh and towel
 Rectal tube placed in a kidney tray
 Vaseline
 Rag pieces in a container
 Hot and cold water in jugs
 Prescribed solution in jug
 Paper bag
 Bucket
 Toilet tray if needed
 Clean linen if needed
 Bath thermometer

7. PROCEDURE
 Wash hands thoroughly
 Prepare the solution at the required temperature
 Attach the tubing and check for any leakage
 Lubricate the tip of the rectal tube about 4 inches
 Separate patient's buttocks to visualize anus clearly
 Insert tip of tube about 4 to 5 inches
 ower funnel below level of rectum
 Empty return flow into bucket
 Fill funnel again. Pour 200 to 300 ml of fluid each time
 Raise funnel and allow fluid to run continuously
 Repeat this process, till return flow is clear
 Remove the rectal tube by using rag pieces

8. GENERAL
INSTRUCTIONS:
 A cleaning enema should be given one hour before the
colon irrigation
 The bladder should be emptied before colonic
irrigations
 The temperature of the solution is kept constant
throughout the procedure
 Allow only 200 to 300 ml of fluid to run into the rectum
at a time
 Make sure that the return flow is not blocked
 Use a smooth and flexible rectal tube and lubricate it
well
 Prevent air entry into the intestines
 Stop the procedure temporarily the patient complaints
of pain
 Listen to the complaints of the patient and should not
ignore any discomfort however small they may be

9. PRELIMINARY
ASSESSMENT
 Doctors order for any specific
precautions
 Diagnosis of the patient
 General condition of the patient
 Self-care ability of the patient
 Mental status to follow instructions
 Any contraindications
 Need for any extra help
 Articles available in the unit

10. INDICATIONS:
 Substance will not bound by activated
charcoal.
 Medications that are slowly released over 12
to 24 hours.
 Massive ingestion with a significant delay.
 Toxic solid object.
 Presence of pharmochomabenzoars.

11. CONTRAINDICATION:
 Rectal infection
 Fistula in anus
 Painful and bleeding hemorrhids
 Painful skin lesions around the anus
 Massive carcinoma or tumors of the
rectum
 Loose sphincter
 Polypus and diverticula of the intestine

12. COMPLICATIONS:
 Nausea
 Vomiting
 Abdominal cramps
 Blotting

13. PREVENTION &
MANAGEMENT
 Health teaching
 Adequate intake of diet & fluid
 Adequate intake of fibre in diet
 Establishing a habit pattern
 Relaxation
 Privacy
 Posture
 Exercise
 Use of laxatives , suppositories & enemas