Effect of different infusion regimens on colonic motility and efficacy of colostomy irrigation.
The colonic motility response and short-term clinical effectiveness of colonic irrigation was studied in five patients with an end-colostomy, each of whom was studied on up to six occasions, using volumes of 500 and 1500 ml water infused under gravity and over a period of 2.5 and 5 min with a pump. The median baseline colonic luminal pressure was 14 cmH2O and rose to 42 cmH2O with a 500-ml infusion, and to 74 cmH2O with a 1500-ml infusion. Irrigation induced high-pressure (over 200 cmH2O) propagated waves which caused the efflux of colonic contents. These were more numerous after a 1500- than a 500-ml infusion (median 4.5 versus 2.0 respectively). There was no difference between the two volumes infused in the incidence of colostomy break-through before subsequent irrigation. Colostomy irrigation with 500-1500 ml water appears to produce intracolonic pressure rises that are safe. These volumes can be infused rapidly under gravity alone.
Gattuso
J M
JM
St Mark's Hospital, Northwick Park, Harrow, UK.
Kamm
M A
MA
Myers
C
C
Saunders
B
B
Roy
A
A
D000368:Aged; D003125:Colostomy; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D011312:Pressure; D007507:Therapeutic Irrigation; D016896:Treatment Outcome