tag:blogger.com,1999:blog-30499448.post183635491922960293..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: No Frickin' Way, Doc!Sid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger46125tag:blogger.com,1999:blog-30499448.post-85490550840296607012020-11-16T15:34:26.306-08:002020-11-16T15:34:26.306-08:00I was thinking a lot about ileostomy and colostomy...I was thinking a lot about ileostomy and colostomy for last few days. I believe it's fair to let people have a choice if It comes to something like this. Some people can imagine living like this and some may not. I wouldn't have mentally enought strengh to handle this. I'm dealing alredy with so many mental health problems, visiting psychiatrist regullarly, get my medications, regular psychotherapy and I stuggle with my self-acceptance even without having ileostomy. Thought that people can normally function is not an argument for someone who would mentally not handle it. Life matters but sometimes the quality of the life may become so low to one individual that death seems to be a relief in comparison. I would never recommend refusing this life-saving surgery to anyone, but If someone is certain about the decission he's about to make I would totally respect that. Lunohttps://www.blogger.com/profile/15498690558454227026noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-19736500792046570092017-12-03T15:49:47.616-08:002017-12-03T15:49:47.616-08:00In life or death situations, no surgeon can be omn...In life or death situations, no surgeon can be omniscient. I have to assume yours chose to save your life instead of letting you die. I infer you're young. Hard to imagine, unless specifically told not to, that any surgeon would have chosen differently. I also assume you had emergency removal of your entire colon, rectum, and anus, although that's unusual for emergency surgery. If you have a remaining anus, it's not impossible to reestablish continuity.<br /><br />I don't think there's anything in my post here that's a lie. And I'm well aware that ostomies are life-changing. You have reason to be angry at the hand life dealt you. You have no reason to be angry with me. In any case, I wish you well.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-28308044702058154902017-12-03T15:18:34.574-08:002017-12-03T15:18:34.574-08:00Sorry doc, but I'm in my 30's and was give...Sorry doc, but I'm in my 30's and was given an ileostomy during an emergency surgery. It was not expected and when I woke up and saw it, I wished I had died instead. I still do. It negatively impacts my life in ways I never could have imagined, and it has been extremely hard to find a romantic partner who can get over the "gross factor." I have had my ostomy for a year now, and I am no closer to accepting it than I was when I first woke up from surgery with it. Please don't lie to your patients and act as though this were nothing and they should just suck it up and deal. It isn't nothing. If I cannot be reversed soon and have a decent quality of life afterwards then I will take my own life. The ostomate life I have now is nothing short of torture. Please be aware of this when making recommendations to your patients.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-35374003334000952652015-12-23T07:51:49.095-08:002015-12-23T07:51:49.095-08:00Well said, Mr Befumo.Well said, Mr Befumo.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-19294108220233625312015-12-23T05:44:28.917-08:002015-12-23T05:44:28.917-08:00I guess it beats the alternative (being dead), but...I guess it beats the alternative (being dead), but honestly, hearing about all these other people doesn't make it any less of a drag. The worst part is the incessant ITCHING under the appliance! "Misery Loves Company" really doesn't apply here...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-19938815930497197302011-10-08T18:59:51.128-07:002011-10-08T18:59:51.128-07:00I jusst came across this post and so glad I did. I...I jusst came across this post and so glad I did. I had a colonoscopy done 2 weeks ago and was told I likely have FAP after 100 polyps were found. My pathology says the large one in my rectum has sever dysplasia (sp) and it all has to come out. Well that doesn't FLY with me. The top of the line surgeon I went to who I booked surgery wtih and now am going to cancel it Monday said I might have a jpouch or a stoma. Well I only was going to sign up for the IRA, not the other 2. I don't want it, I rather risk it and I don't get why I can't have the large polyp removed and see if it comes back as well as burn the smaller ones out. <br /><br />I am not seeing the genetic doctor until after my surgery and everyone says I am running out of time, I will be dead in 2 years. How can you say it is FAP when nobody else in my family has it and I haven't been tested for the gene. Well I am not ok with the surgery options presented to me. I don't get why chemo can't get some of it under control. If anyone wants to read my blog and get in touch, please do.<br /><br />http://vanessaic.wordpress.com/Vanessahttps://www.blogger.com/profile/06352133489684710089noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-4972254482034803232010-09-11T08:47:10.668-07:002010-09-11T08:47:10.668-07:00Thanks for that excellent comment.Thanks for that excellent comment.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-39117704587746784132010-09-10T22:32:17.251-07:002010-09-10T22:32:17.251-07:00I can't believe how uninformed some people are...I can't believe how uninformed some people are about life with an ostomy. I didn't have a choice, I went from ulcerative colitis to toxic megacolon and emergency surgery in 2 weeks. There are LOTS of people in their 20s (and far younger) who are living life to the fullest with their ostomy and partying, wearing tight clothes etc. I suggest checking out http://www.uncoverostomy.com and http://www.nogutsknowglory.com. The first website is from a 21 year old model, actress and university student with an ostomy and the second is a young man who just finished climbing the 7 highest summits in the world by conquering Mt Everest in May. There are ostomates who are race car drivers, police officers, black belts, compete in body building (yep with the skimpy little briefs and yep, ostomates who regularly wear bikinis. They are living life to the fullest and like me are trying to shatter the stigmas associated with these much misunderstood surgeries. <br /><br />There are many people on Shaz's board (http://www.ostomates.org) and the UOAA discussion forum (http://www.uoaa.org) who have resisted having an ostomy for MANY years and finally did and they now wonder why they didn't do it a long time ago as they've been able to return to an active life and do things they could never do when they had ulcerative colitis. <br /><br />Oh yeah, and they get married and have kids. I didn't choose to have an ostomy, but I celebrate each year the anniversary of my ostomy surgery, even though I nearly died of complications afterwards. I'm still here, and I am doing my best to ensure these stigmas are shattered and people see there is life after ostomy surgery.<br /><br />I even blog about it, and I too use humor. Yes, I have bad moments, but the good times far exceed the bad and I've met many wonderful people in the ostomate community.<br /><br />http://www.muggins7.wordpress.comAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-33607813932012652032010-07-27T07:54:03.592-07:002010-07-27T07:54:03.592-07:00anonymous: thanks for your well-considered comment...anonymous: thanks for your well-considered comments. My intent, in this quite old post, was to reassure those who need ostomies that they may not be as bad as they think. NEED is the operative (as it were) word. When it can be safely avoided, it should be.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-39229293382864809692010-07-27T00:34:38.089-07:002010-07-27T00:34:38.089-07:00A few interesting alternatives to colostomy:
http...A few interesting alternatives to colostomy:<br /><br />http://blogs.discovermagazine.com/discoblog/2009/11/19/so-long-colostomy-bag-british-man-gets-remote-controlled-sphincter/<br /><br />http://www.bowelcancerresearch.org/changing_lives/article.php?article=7<br /><br />http://clinicaltrials.gov/ct2/show/NCT00059891<br /><br />http://www.bowelcanceruk.org.uk/home/media-centre/latest-news/saving-my-arseAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-58406666591067796022010-07-27T00:03:57.104-07:002010-07-27T00:03:57.104-07:00ps (sorry Dr Schwab, I will shut up after this ;-)...ps (sorry Dr Schwab, I will shut up after this ;-)<br /><br />I should note I have also made lifestyle changes since being diagnosed. I now eat a small protion of meat only once a week (it has been recommended that consumption of red meat should be restricted to no more than 500g per week - any more increases the risk of colorectal cancer), fish once a week and all remaining meals are vegetarian. I eat mostly organic, locally produced (and where possible, home grown) produce. I avoid highly processed foods. I don't buy into the 'sugar feeds cancer' myth but I do manage what I eat to avoid fluctuations in blood sugar levels and I cut out simple sugars as much as possible anyway.<br /><br />I exercise every day, without fail. Regular exercise has been shown to decrease the risk of a recurrence of colon cancer by up to 50%. It hasn't been shown to have the same impact with rectal cancer but it certainly can't do any harm!<br /><br />I had my vitamin d levels checked (colorectal cancer patients have been shown to have low levels of vit d) and now take regular supplements of vit d + calcium. I am also on mini-aspirin (aspirin has been shown to decrease the risk of colorectal cancer).<br /><br />I was told to exercise regularly but the other changes, supplements and addition of aspirin are as a result of my own research. I asked for the vitamin d test (it's not usually a standard test but easy enough to add on when you're getting blood sucked out of you regularly anyway) and I asked about the aspirin.<br /><br />Here's a good website with more info on colorectal cancer: fightcolorectalcancer.org/Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-15188135528660987002010-07-26T23:45:51.685-07:002010-07-26T23:45:51.685-07:00cont. from above:
My choice was to do everything ...cont. from above:<br /><br />My choice was to do everything possible to avoid the bag, even if it meant taking a risk that the cancer would return. So I had an excision rather than radical surgery. I didn't even have to have a temporary bag (phew!). Yes, I would have had to have a temporary bag if I hadn't had such a good response to chemorad. Yes, the surgeon who I first saw (and the next couple after that) would still have performed an APR, even despite my good response to the chemorad. But I did have a good response & I had a great oncologist & a great surgeon who respected me & my decision. <br /><br />I did, of course, have to have adjuvant chemo - xeloda with oxaliplatin (the oxy SUCKED the big one but the resultant neuropathy did wear off with time). I also need more regular follow up (scans, blood work etc.) than if I’d just had an APR – small price to pay though!<br /><br />I'm only mid 30s & I admit I am pretty vain about my appearance so that played its part in my decision. I guess it might have been different if I was a guy or much older & 'over the hill'. But I have never regretted my decision & like I said, I'm 2 years NED. According to my doctors, that is a great sign as most recurrences (over 80%) occur within the first 2 years. <br /><br />I don't mean to 'bag' having a bag but I want people to understand that when you have a low tumour, you need to make absolutely sure you get the best possible treatment. Don't just accept the first opinion you get!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-16278368663869499042010-07-26T23:44:20.309-07:002010-07-26T23:44:20.309-07:00To the person in their 20s - if you're facing ...To the person in their 20s - if you're facing a colostomy due to cancer, PLEASE get multiple opinions rather than just going ahead with the APR. <br /><br />If I had stuck with the original surgeon I saw when I was first diagnosed, I would have ended up with a bag unnecessarily. The surgeon was adamant that I would have to 'get used' to having a bag & that was that. As far as I was concerned, that was not an acceptable prospect for a young woman. As it was, it took me 3 more goes to find the right surgeon for me & I am now both bag-free & cancer free 2 yrs later. <br /><br />To be honest, avoiding a bag became my primary goal over & above curing the cancer - but I'm lucky & very grateful that everything has worked out (so far - touch wood!). I have both my oncologist & my awesome surgeon to thank for this.<br /><br />Here are a few things I learnt along the way:<br />* if you have a low tumour, 6 weeks of neoadjuvant chemoradiation is non-negotiable. I had xeloda, 5 weeks of radiation to the pelvic region then 1 week of radiation targeted to the tumour (that’s radiation + chemo Monday-Friday with weekends off). There are studies now showing that the addition of Avastin to chemorad improves response rates even more (in some cases, it up to doubles the chance of a near-complete or complete response). Also, xeloda is slightly more effective than 5FU.<br />* you MUST find yourself a board certified, specialist colorectal surgeon. Studies show that hospitals where high rates of colorectal cancer are performed have lower rates of permanent colostomies. Interestingly, the first surgeon that I saw who told me I'd HAVE to have a bag was a general surgeon & wasn't board certified.<br />* you also need to find a progressive oncologist who doesn't simply stick with the 'standard' approach but will go the extra mile if necessary. On top of the neoadjuvant chemorad, I had additional full strength xeloda before surgery. <br />* studies show that the optimum time between ending chemorad & having surgery is between 8-12 weeks. The chemorad keeps working during this break so if you have surgery sooner, the chemo hasn't had the chance to finish working.<br />* your response to chemorad is critical. Before any treatment, I was Stage III with one suspicious enlarged node. I had a near complete response to chemorad + chemo & was down staged. When you have such a good response to chemorad, the chance of you still having positive nodes (assuming there were any to begin with - enlarged nodes do not guarantee that they are cancerous, they may just be inflamed) is greatly reduced. From memory, there's only about a 5% chance of positive nodes turning up in final pathology if you have had a complete response to chemorad. <br />* you need to be your own advocate. As Dr Schwab points out, some people adapt to having a bag. But if you want to give yourself the best possible chance of avoiding that outcome, then you need to understand beforehand what the alternatives are & decide whether you can accept the possibility of an increased risk of recurrence. An oldie who just wants the safest way may accept radical surgery without question. But I knew I was WAY too young to have to make changes to my life because of a bag that I could have avoided. I took the risk & accepted a slightly greater risk of recurrence. I found an oncologist who was prepared to provide additional treatment to give me the best chance of having the surgery I wanted, then when I had a good response, I found a surgeon who accepted that I'm ultimately the person who decides what is best for me & what I could live with.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-73319693252079584412010-04-11T11:30:41.107-07:002010-04-11T11:30:41.107-07:00Well, first off the commenter suggests that all su...Well, first off the commenter suggests that all surgeons care about is butchery, which is a bit off-putting. And I guess it's how one sees it. No one would choose an ostomy if there were a better option. But when it's done, it's for a reason: in the case of UC, I never had a patient say it wasn't worth it, because they'd been so sick for so long they'd forgotten what well feels like. <br /><br />The problems the commenter mentions are real, but he/she puts a very negative spin on them all. People get very good at managing their ostomies -- better than their docs, their ostomy nurses. It becomes a part of life; not a pleasant one, but necessary, manageable, and not limiting in any way.<br /><br />I'd suggest you look at websites for ostomates. Like <a href="http://www.c3life.com/ostomy/ostomybasics/default.aspx?gclid=cp2jtksj_6acfq5biaodla5a0w" rel="nofollow">this</a> or <a href="http://www.ostomates.org/" rel="nofollow">this</a>.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-41730626634225651012010-04-11T10:48:34.352-07:002010-04-11T10:48:34.352-07:00Dr Schwab, thanks for your blog.
Could you please...Dr Schwab, thanks for your blog.<br /><br />Could you please explain why you think the last 'anonymous' is mis-informed? I'm in my mid-20s faced with the prospect of a bag and need those myths properly expelled from my mind.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-38060860200892263492009-01-28T08:51:00.000-08:002009-01-28T08:51:00.000-08:00anonymous: thank you for your thoughts on this. It...anonymous: thank you for your thoughts on this. It's a difficult decision. It appears, from what you've said, that you are far from fully informed, and that's too bad. <BR/><BR/>On the other hand, I'm inclined to think this isn't a "real" comment from a "real" person. I was inclined to delete it because I'd guess I'm right. But I'll leave it because it's an example of what actual people might think who have poor knowledge of the options.<BR/><BR/>It's also the case that my post here was about cancer and not ulcerative colitis, about which there are even more complex issues. Finally, I'd not be inclined to give general credence to one who thinks she knows what "the majority of surgeons" think. But that's just me.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-25548451824245659292009-01-28T02:28:00.000-08:002009-01-28T02:28:00.000-08:00I agree entirely with the 30yo with ulcerative col...I agree entirely with the 30yo with ulcerative colitis. <BR/><BR/>I am in my late 20s, single, into partying and casual relationships and very sporty. I have been told that an upcoming surgery that I will have (to remove cancer) will leave me with a permanent colostomy. As far as I'm concerned, there is no well in hell that I am going to consent. Who at my age wants to end up being a shit bag attached to a body for the rest of your life? <BR/><BR/>I'm happy with my life so far and I'm not prepared for the drastic reduction in quality of life that having a bag entails. It's funny, everyone I know of or who have interacted with who has a bag says 'it's not that bad' ie what they're not saying is that it's shit (literally and figuratively) but they put up with it. Oh sure you might be able to go hiking, swimming, horse riding, skiing etc. Big deal - how much preparation do you need to do so that you can do all those things? Having to carry spare bags, glue etc. on you all the time - how fun is that!? It's not like you can just think to yourself - I need to go to the bathroom but I'm just going to hold on until I'm busting because I'm busy at the moment. Bags do burst and leak (yeah, go on about the fantastic supplies there are these days as much as you want - the reality is that none of them are foolproof). Mmm, shit dribbling down your front - that's nice for everyone around you, isn't it! <BR/><BR/>I know that if I met someone I was interested in romatically and found out they had a colostomy, that's it - I wouldn't want to touch them with a barge pole. I'm not saying I wouldn't want to know them - just that I wouldn't want physical contact with them. And I'm not prepared to have to constantly watch what I eat, spend hours in a bathroom emptying the stinky slops or fart at inopportune moments or have to throw out all my skin tight, slinky party clothes, boob tubes and bikinis.<BR/><BR/>This surgeon's post is representative of the majority of surgeon's opinions - ie no consideration for quality of life issues, especially where younger patients are concerned. All a surgeon sees is a tumour with a body attached - they don't give a shit (excuse the pun) what you have to deal with afterwards as a result of their butchery.<BR/><BR/>I've made my choice and I'm at peace with it. It's a shame that noone has done enough research to come up with acceptable alternatives.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-83802984015067662282008-12-18T21:09:00.000-08:002008-12-18T21:09:00.000-08:00It isn't bad at all and isn't even all that unattr...It isn't bad at all and isn't even all that unattractive. I have one and it is one of those things that one gets used to and you all would be surprised at how accepting the opposite sex is of it. <BR/><BR/>It can't be helped, I would be dead now from sepsis if I didn't do it. Yes, I cried and was very upset about it at first. Eventually, I came around and never feel I did the wrong thing.<BR/><BR/>The hardest part is being intimate with someone new. One never knows how they will view such a hack job that a colostomy appears to the unaccustomed. Other than that, no one ever knows.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-6008895918893565282008-08-09T10:02:00.000-07:002008-08-09T10:02:00.000-07:00I'm a 30 year survivor of ulcerative colitis....an...I'm a 30 year survivor of ulcerative colitis....and I'd be one of the people who WOULD say, "No Frickin' Way!" to a colostomy if they said I've have to have one. I've fought like a dog these last 30 years to NOT have go through that. I know people who've had ostomies. They tell me they're just trading in one set of problems for another. I find the idea of wearing an ostomy bag repulsive. I'm not weird or anything, just a normal person who thinks the idea of wearing an ostomy bag is the most horrible thing that could happen to anyone. I'm hoping and praying my UC never gets to that point, because I'd say NO and I wouldn't change my mind.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-83437900917857246282008-07-23T20:33:00.000-07:002008-07-23T20:33:00.000-07:00I know you are all serious doctors, but I am the d...I know you are all serious doctors, but I am the daughter of an ostomy patient. My family does think that this was a mistake for her, but as one of you mentioned, a permanant stoma is just there and there is nothing to do about it!<BR/><BR/>I am writing a blog about helping my mom. Here it is: http://helpingout.wordpress.com/<BR/><BR/>Warning, I am trying to see the lighter side of this!Isabella Zambezihttps://www.blogger.com/profile/18113363205186486748noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-7792634110416859562007-11-13T13:32:00.000-08:002007-11-13T13:32:00.000-08:00there are several stapling techniques using differ...there are several stapling techniques using different type staplers. It depends on how far into the pelvis is the distal end. If you look <A HREF="http://surgeonsblog.blogspot.com/2007/01/guts-glory.html" REL="nofollow">here</A> you'll see why I like hand-sewing when I can. But a hookup deep in the pelvis is ideal for staplers. <A HREF="http://www.freepatentsonline.com/20030183671-0-large.jpg" REL="nofollow">Here</A> is a diagram that shows one technique. Imagine the left side of the image is the rectum; ie, the stapler inserted through the anus, to bring down and connect to the upper end (the colostomy you currently have.)Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-21123587478238843442007-11-13T13:13:00.000-08:002007-11-13T13:13:00.000-08:00I stumbled on this looking for info on a colostomy...I stumbled on this looking for info on a colostomy takedown. I went in to the ER 8 weeks ago for abdominal pain. They diagnosed ruptured appendix. They went in and found a healthy appendix in a pool of pus. My colon perforated from diverticulitis and they removed 5" on my descending colon. I have it reversed this week. Im trying to understand how the process works. Anyway - interesting article - and if anyone refuses a colostomy they are not thinking it through. <BR/><BR/>I woke up from appendix surgery with one and was quite shocked. Even when they said it was temporary I was freaked out. But after I got home and figured out how it worked - its not worth dying over I can assure you. Thankfully I am cancer free.<BR/><BR/>Thanks for your article and if you can explain how the put the colon back together that would be great. Im trying to imagine how the stapler works.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-34019619388401858662007-03-02T07:36:00.000-08:002007-03-02T07:36:00.000-08:00I know many people who've irrigated forever. I'm u...I know many people who've irrigated forever. I'm unaware of any deleterious effects (it's possible to get overly agressive and cause damage, just as it would be with a careless enema. As long as you provide enough fiber to create solid stool that moves its way to the south end, I don't know of any problems.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-63559607281849780772007-03-01T21:24:00.000-08:002007-03-01T21:24:00.000-08:00Dr. S. -- (I'm having all sorts of hell replying t...Dr. S. -- (I'm having all sorts of hell replying to this thread -- forgive me if this is the THIRD time this tiresome post appears) Thank you for your response re irrigation. I've been doing this procedure since I finished treatment (6 fun-filled months! I can now add the ability to wash my hair while wearing a PICC line in one arm to my Life List of Skills.)<BR/>Irrigation changed my quality of life dramatically, and literally overnight. I do peer-couselling pre and post-op for colostomates and am always astonished at how few [good candidates, too] want to try it. Bit as yous say, it may be too Intimate' for many. I like the term 'intimate'. Nicer than 'creeped out'.<BR/><BR/>Another question: in your experience, are there any negative side-effects associated with long-term irrigation? Such as 'bowel stretching', electrolyte imbalance, loss of bowel motility and impairment of the immune system due to unnatural loss of friendly colon bacteria? I've heard all of these theories. <BR/><BR/>I'm not about to stop irrigation -- to be frank, if it means I don't have to wear bags, I don't care what mayhem I may be causing down there -- but I'm curious to get a surgeon's opinion.blogsnooperhttps://www.blogger.com/profile/06667214666274271598noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-81894697070051897782007-02-28T17:04:00.000-08:002007-02-28T17:04:00.000-08:00blogsnooper: thanks for the kind words, and congra...blogsnooper: thanks for the kind words, and congrats on your success. To irrigate or not is stricly a matter of what works best for the individual. Irrigation is a little too "intimate" for some people, but has the advantage of making it move when you choose rather than when it chooses. People with "well-trained" colostomies who irrigate can often get along without a bag at all, or just a small "security pouch." I think if I had one, I'd irrigate. Many of my patients tried it both ways and ended up not irrigating. So, as I said, it's just about what fits best with individual feelings.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.com