Stoma irrigation among patients with a permanent colostoma-a cross-sectional survey of stoma care nurses in Austria and Germany.

Abstract

Colostomy irrigation is a well-established technique used for bowel management in patients with a permanent, left-sided colostomy. When performed routinely every 24-48 hours, it enables stool-free intervals, often allowing the use of only a stoma cap or simple dressing. Scientific evidence has shown significant improvements in health-related quality of life (HRQoL) for patients using this method. This study aimed to evaluate the current application of colostomy irrigation in Germany and Austria and to identify reasons for its limited use, despite known benefits. A specific focus was placed on the perspectives and practices of stoma care nurses. A cross-sectional, retrospective survey was conducted among certified stoma care nurses in both countries. Data were collected anonymously and analysed descriptively, including the use of interval-weighted means. A mean of 39 patients per stoma therapist per year with a permanent colostomy in the descending or sigmoid colon-regions anatomically suitable for irrigation-were reported. However, irrigation had been recommended to only 43.6% of these patients, and just 53% of those adopted it in daily practice. This results in an average of only nine patients per stoma expert using the technique annually. Reported barriers included time constraints, perceived patient reluctance, short inpatient stays and doubts regarding clinical indication. Stoma irrigation therapy has shown potential to improve autonomy, self-image and everyday function. This study contributes valuable insights into under-explored care practices in the German-speaking context and underlines the need for enhanced training and awareness among healthcare professionals to better integrate irrigation therapy into routine care.