Bowel Wash Procedure Nursing Foundation

1. Bowel Wash
1st Year Students
Amity College of Nursing (ACON)

2. Bowel wash or colonic lavage or enteroclysis is defined as
washing out colon with large quantities of solution.

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. Contraindications
• Rectal infection
• Fistula in anus
• Painful and bleeding hemorrhoids
• Painful skin lesions around the anus
• Massive carcinoma or tumors of the rectum
• Loose sphincter
• Polypus and diverticula of the intestine

5. 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

6. Methods used for
Bowel Irrigation
Funnel and catheter
Y connection and a rectal tube
Two tube method

7. 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

8. Temperature of
The solution
Cleaning purpose 104 degree F
Thermal effect 110 to 115 degree F
Reducing temperature 80 to 90 degree F

9. 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

10. 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

11. 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

12. 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

13. Procedure
Of bowel wash
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

14. 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

15. References
• https://nurseinfo.in/bowel-wash/
• https://www.slideshare.net/arifasudheer/bowel-
wash-and-insertion-of-flatus-tube

16. Remember…
Safety First!
Thank You…