Colostomy irrigation—A transatlantic controversy

Summary Colostomies are managed chiefly by irrigation in the United States, by “natural evacuation” in the United Kingdom, and by both methods in Canada. Fifty colostomy patients attending the Nova Scotia Tumour Clinic, half of whom irrigated and half of whom did not, were interviewed and examined. Those who irrigated regularly generally were more successful in reducing the number of daily colostomy movements and the amount of gas and odor. Those who irrigated daily were most successful of all. Nevertheless, 40 per cent of the non-irrigating patients managed well, chiefly because of previously regular bowel habits. Diet did not play a significant role. A flexible approach to colostomy management is recommended, and one such approach is described.