whole bowel irrigation

whole bowel irrigation

1. WHOLE BOWEL IRRIGATION PRESENTED BY: G.MANJUNATH & K.TRILOK

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

5. 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

6. 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

7. 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

8. 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

9. 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 .

10. 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

11. Complications : Nausea Vomiting Abdominal cramps Blotting

12. 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