What is a rectal irrigation?
A rectal irrigation is done to get poop and gas out of the bowel by using a catheter (a tube) and small amounts of normal saline.
Why Normal Saline?
It is important to use fresh normal saline. Old saline can have germs and germs can cause infections. Although you can buy normal saline, it is cheaper and can be easier to make a fresh supply of normal saline every day.
How to make Normal Saline?
- Mix 1 cup (8 ounces) of tap water with ¼ to ½ teaspoon salt and a pinch of baking soda.
- Keep the normal saline in a covered bottle or glass for no more than 24 hours. After 24 hours, throw the solution away, wash the container and make a new batch of solution.
Steps for giving your child a rectal irrigation
- Wash your hands.
- Gather supplies:
- Silicone Foley catheter (tube)
- 10 French for preterm newborns
- 12-14 French for term newborns (infants <28 days)
- 16 French for patients 28 days to < 1 year
- 24 French for patients 1 year and older
- 60 mL slip tip syringe
- Water soluble lubricant, like KY Jelly
- 2 non-sterile basins, like an emesis basin
- Normal saline solution
- Towel for your child to lie on
- Pour room temperature normal saline into one of the small basins.
- Draw up the amount your child’s provider told you to use into syringe and set aside on a clean surface.
- Have your child lie on a towel and help them to a comfortable position on their back with knees bent to their chest or lying on their left side.
- Cover the tip of the Foley catheter with the water-soluble lubricant.
- Gently insert the catheter into the rectum until resistance is met. Allow any stool or gas to come out into the second empty basin. Do not force or push the catheter further than the divider ports of the catheter.
- Do not inflate the balloon of the catheter as this could cause damage to the rectum or a tear in the bowel.
- Connect the syringe with normal saline into the end of the catheter and slowly push the instructed amount into catheter.
- Remove the syringe from the end of the catheter and allow normal saline to drip into the basin.
- If only a small amount of normal saline or stool comes out take these steps:
- Move the catheter back and forth to allow pockets of stool and fluid to drain.
- Gently rub the abdomen to increase drainage.
- Attach an empty syringe to the end of the catheter and gently pull back on the syringe. Do not pull back on the syringe if you feel resistance.
- Remove catheter to look for a blockage caused by stool. Follow steps 6 – 8 to reinsert the catheter when the blockage has been cleared.
- Repeat steps 4 – 12 until the fluid draining from the catheter is clear.
- Remove the catheter, once the fluid that drains out of the catheter is clear and clean your child.
- Wash the syringe, catheter and basins with soap and water, then let them dry. These supplies can be reused.