Bowel wash or colonic lavage
Bowel Wash
- Bowel wash or colonic lavage or enteroclysis is defined as washing out colon with large quantities of solution.
- Bowel wash is defined as the procedure in which the colon is cleared off of the fecal matter using large volumes of solutions.
- It is, basically, the washing of the colon.
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
Contraindications
- Rectal infection
- Fistula in anus
- Painful and bleeding hemorrhoids
- Painful skin lesions around the anus
- Massive carcinoma or Rectal Tumors
- Loose sphincter
- Polypus and diverticula of the intestine
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
Solution used for Bowel Irrigation
- Tap Water
- Cold Water
- Normal Saline
- Sodium Bicarbonate 1-2%
- Antiseptic solution KNMO4
- Boric solution 1 to 2 %
- Tannic acid 1: 100
- Alum 1: 100
Temperature of The solution
- Cleaning purpose 104 degree F
- Thermal effect 110 to 115 degree F
- Reducing temperature 80 to 90 degree F
Method used for Bowel lrrigation
- Funnel and Catheter
- Y connection and rectal tube
- Two tube Method
Preliminary Assessment Check
- 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
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
Equipments -A clean tray containing
- 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
Procedure Of bowel wash
- 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
- Lower 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
After care Of bowel wash
- Remove rectal tube by using rag pieces
- Discard rag piece in to K-basin
- Place patient comfortably, provide bedpan if needed
- Change linen if soiled, replace equipment after cleaning
- Wash hands
- Record the procedure in nurse’s record sheet