The catheter needs to be inserted far enough so the balloon sits in the right position in the rectum (bottom). Your nurse will show you exactly how far to put it in.
In which position should you sit?
It is important to sit comfortably on the toilet using a seat reducer and step for the feet if necessary. Sitting with the knees slightly higher than the hips is the best position.
How much may I inflate the small catheter using Navina Classic on a child?
As each child is different your nurse will advise you but in general we suggest starting with 1-2 pumps and increase only as necessary to maintain a good seal and prevent the water leaking back out.
How does that work for Navina Smart?
Again be guided by your nurse who will advise you what settings to use. We often find that initially children may only tolerate a small balloon volume but as they get used to procedure they become comfortable with the most effective inflation.
How much water should be pumped in?
The volume of water depends on the size of the child and their initial tolerance to the irrigation so in some cases we would start with 100 ml and gradually increase until the most effective volume is reached. In practice the average volume is around 500 ml but it can vary enormously between individual children.
How often will we need to do the procedure?
From the start it is good to irrigate every day and after an initial period of 1–2 weeks, most people can slow down and irrigate every other day.
How long will it take?
For most children irrigation takes 15–60 min.
Can my child do it on his/her own?
Yes that would be the aim. However children should always be accompanied by an adult caregiver, who performs the procedure, until that caregiver considers the child able to perform the procedure by himself/herself.
What is a normal routine?
The ‘normal’ routine is whatever fits within your family lifestyle. For most children, with and without bowel dysfunction, the bowel works in a regular manner. It is therefore good to also irrigate regularly – most families find the evening, about 30 mins after their meal to be the most practicable.
For how long should the children try the procedure before it is effective?
Most families find a routine and pattern that works within the initial "tuning" period (4–12 weeks).
Does it hurt?
Some children express fear and worry about start using TAI. TAI should not hurt but some children may interpret ‘normal’ peristalsis (movement of the bowel) as discomfort when they first experience the irrigation working.. If the water is too cold it may cause stomach cramps. The water temperature should be 36–38 °C.
I followed the instructions but no feces came out?
Abdominal massage, coughing or movement may encourage the water to come out. It may be due to constipation or dehydration. Irrigating 30 minutes after eating or drinking may help to stimulate the natural activity of the bowel. If the problem persists then contact your nurse.
Is it ok to use tap water?
You should irrigate using clean lukewarm tap water (36–38 °C). As a general rule, if you can drink the water it is okay to irrigate with.
Do I have to wash my child afterwards?
Some parents find showering in conjunction to irrigation is a good routine, but it is not necessary, as long as your child stays clean and dry. The child will just need to wipe their bottom as they would after a ‘normal’ bowel movement (poo).
What about diet, can my child eat and drink whatever he or she want?
Eating a varied diet is good for digestion and bowel health and recommended for everyone.
How does it work in school?
It is not a procedure that would be carried out in school.