When it’s hard to insert the catheter

When it’s hard to insert the catheter

            Most of the time the catheter slips into the stoma easily, especially when you use a little lubricant. At other times – thankfully few – it gets a little ornery. There are a couple of reasons.

            It doesn’t take long for most of us to figure out what direction to aim in when we insert the tip of the catheter and it’s pretty consistent. Although the colon-turned-bladder doesn’t really float within the abdomen, it’s not anchored in place, either. The segment of small intestine (ileum) that leads from the pouch to the exterior may shift a little, especially if a person has been constipated for a few days and there is a sizeable accumulation of stool to push it this way or that. It doesn’t take much to change the orientation of the ileal segment.

            Another cause is simply spasm of the ileal segment.  When stimulated by touching, the bowel tends to react by contracting, thus clamping down on the catheter. Just whistle a few bars and the spasm will subside.

            It’s important not to push too hard or too fast on the catheter. The lining of the intestine is fragile and you might cause some bleeding. Frank perforation is unlikely.

            Don’t try to withdraw the catheter too quickly. That will also cause the ileal segment to contract and clamp down on the tubing. Another reason to withdraw the catheter slowly is to drain all the urine. The colonic pouch that serves as a bladder is more irregular than the original urinary bladder and it doesn’t have the elasticity that the old bladder did. It sometimes takes a little manipulation to completely empty it.