Hey guys,

I have been scouring the site for people with this problem, but have yet to see it. I am only 6 weeks out of surgery, and am finally really getting the hang of intubating. But, no matter how much grape juice and mylanta I take, I HAVE to flush multiple times to clear the pouch. None ever comes out without the flush. And I'm talking 20-30 flushes of 20-30cc each.

Anyway, like every other time I intubate and begin to flush, I have output that squirts out between the tube and the stoma. And when I say squirt, I mean squirt! It has flown a couple of feet a few times. Either way, it makes a mess, and I'm feeling a bit like a mother with a new baby. Like I'm gonna be covered in **** for the rest of my life. I'm going back to work next week and fear having this problem occur while there. It has gotten on my clothes before.

Does anyone have this happen? I have tried different angles and distances out from the stoma. I've positioned myself differently. It doesn't even seem to matter the consistency of the output. It happens when it's really loose and really firm, although obviously the loose ones are much messier!

What do I do? Is there anything? Is this just maybe my valve and pouch are still healing and this problem will go away? If so, when?

I'd appreciate anyone's help on this sticky situation.

Rachel

Hi Rachel,
Ok, Yes, It has, did and does still happen to me but less and less....first up, what are you eating for your stool to be so thick? Are you drinking sufficient fluids, and by sufficient as compared to your level of physical activity and the weather out there...heat, activity and sweat can dehydrate you to the point of having thick stool...if grape juice doesn't do it for you then try prune juice. Ok, I know, butit really is an acquire taste! Really . My Dr. started me on a pot of coffee every morning and a glass of P juice before breakfast. I promise that unless you have been eating really high fiber and high carb stuff, you will 'wooosshh' right out the tube! Saniflush! In the begining please try it a couple of hours before leaving the house or even the P juice before bed time and the coffee in the morning (can be reasonably weak coffee, not a quart of expresso !) It has been 30 years and it works every time. As for the leaking, it may just be that your stoma is not 'tight' yet as you were on strait drain for quite a while. It should tighten up a bit with time but be careful not to pull down on the tube while intubating, it can be part of the problem ( I do it unconsciously when stressed or uncomfortable..squirt !) Also try not to wait until you are overfull. If you irrigate with a full pouch then the water and stuff is forced out around the tube and well..you know what happens then...more prune juice, more liquid and a more frequent intubation especially when working should help you..
Good luck going back to work
Sharon

That is basically the answer I got from Dr. L. He thinks I am flushing too much. He says to intubate, wait 30-60 seconds, and what comes out comes out.

But nothing comes out! I read that some people get stopped up from antihistamines, and I take those every day. I suppose I must work with my diet. Mylanta works, but my belly is SO noisy when I take that. Gurgle, gurgle. I used to drink a lot of coffee, but I quit when I was diagnosed 6 years ago. There is still one pathology report that indicated chrones, so I'm afraid to go to crazy with the coffee.

Thank you so much for your support. I put your number in my cell for emergency k-pouch info!

Thanks again!

Rachel

Hey guys...
This is my 2nd post...1st is the 'tube question' on the forum and if you look at those results you'll see that so far I'm the only respondent that intubates...so will you allow an 's-poucher' to follow along with some of your discussions?!

I can relate to many of your problems even though I'm draining out my rear. I am having trouble finding a replacement draintube. The type of rectal catheter I'm currently using is no longer available (32Fr-that I cut to about 12 inches long). Can you suggest suppliers that have a wide variety of drain tubes to sellect from? This is harder than I ever imagined it would be. My last two attempts at new, different tubes that are available don't cut it! Also, I would be interested to hear what size diameter works for you...very interested!

Thanks! dave in montana

I am about 4 months post op and whenever I am flushing and liquid comes out between the stoma and the catheter I don't have the catheter in far enough and I think I am putting water in the valve. Make sure the catheter is as far in as you can get it then try flushing.

As for where to get Catheters Edgepark Carries a marlen 32 but continentostomystore.com has a large selection of catheters.

I have a K-pouch and I use the French 30 Medena catheter from Torbot.

I have had a Koch pouch for 16 months now. At first I had great difficulty in emptying it as the output was much too thick. I was advised to have 2 ounces of prune juice several times a day and this certainly did the trick. In fact I had to stop taking it after a few months as it was making me too dehydrated. I found that apple juice worked just as well.
When I was first shown how to insert the catheter the stoma nurse put a mark on it just over 4" from the tip and I have always used this as a guide because then I know that it is in the correct place. I introduce the catheter in a sitting position and empty it into a jug. I have found it easier to lean backwards slightly against a wall. It is important to make sure that the abdominal muscles are totally relaxed.
Frequently the contents can leak around the catheter especially if there is a slight blockage but now I always wrap some tissue around it and also place some below the area so that it cannot trickle into the groin.
Probiotics and certain foods can make the contents very liquid and if there is gas present then liquid shoots out of the catheter and goes everywhere. Be sure to hold some tissue over the end just in case.
If nothing comes out at first it can be helpful to gently massage the abdomen once everything is fully healed.
I hope that thse tips might be of some help.
Julie