Hints and Tips for Patients

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Efficient Refeeding

  1. Reinfuse chyme when The Insides® Pump is completely submerged in chyme, reinfuse little and often.
  2. Make sure the pump is changed at least every 3rd day. 
  3. If you’re experiencing nausea, bloating, and/or stomach cramps – reduce the speed and slowly reinfuse. Only reinfuse 1-2 times per day under the guidance of your health care professional until it resolves.  Discomfort will reduce over time, if it continues for longer than 2 weeks, please contact your health care professional.
  4. Release excess wind in the ostomy appliance. Press out the wind via the opening at end of pouch or uncoupling the pouch from the base plate.
  5. Do not let the ostomy appliance overfill. Refeed once you see The Insides® Pump is submerged.
  6. Ensure you are eating a low residue/low fiber diet as per your dieticians’ instructions. Eat slowly and chew your food well. Swallowing air while eating can increase wind (i.e. carbonated drinks). Avoid drinking through a straw or chewing gum. 
  7. Do not refeed chyme which has been sitting in the ostomy appliance for longer than 8 hours.
  8. There will be approximately 20ml of chyme sitting in the bottom of the ostomy appliance when you finish refeeding due to it sitting below the level of the Pump. As you become more independent, you will be able to fold up the bottom of the ostomy appliance and refeed it or you may choose to discard it. 
  9. When changing the ostomy appliance, remove the pouch slowly! Practice with a stoma nurse until confident.
  10. Charge The Insides® Driver when the lightning bolt flashes amber. It will take 4 hours.
  11. Ensure you fill in the logbook every day. 


  1. If the tube falls out - contact your health care professional that is monitoring you on this device, do not replace The Insides® Tube yourself.
  2. If you’re experiencing reflux around The Insides® Tube it does not cause harm but will increase the reinfusing time. Reflux is expected when you are rehabilitating the distal bowel.
    1. Use the lowest speed that moves the chyme through The Insides® Tube.
    2. Reinfuse a little and often to allow the intestine to absorb the chyme that has been pumped.
    3. You may be constipated downstream – under the guidance of your health care professional, ensure you are reducing your anti–motility drugs i.e. Loperamide.
    4. If reflux continues, please contact your health care professional.
  3. If chyme is not moving up the tube, there could be several reasons:
    1. Blocked pump: - Change The Insides® Pump. Avoid stringy fibrous food which can block The Insides® Pump.
    2. Ensure The Insides® pump is fully submerged in the chyme.
    3. If your chyme is too thick, discard into the toilet and work on thinning your output for the next reinfusion. Drink a glass of water or cup of coffee.
    4. The Insides® Driver– Ensure all speeds have been tried for a minimum of 30 seconds each, sometimes the thicker consistency’s move slowly up The Insides® Tube.
    5. Not coupled correctly– Ensure the flat surface of The Insides® Pump has been cleared of debris and intuitively couple The Insides® Driver with The Insides® Pump through the ostomy appliance. Carefully hold The Insides® Driver up and The Insides® Pump should remain coupled. This demonstrates they are coupled effectively.
    6. The Insides® Driver bounces off The Insides® Pump– This can happen at speed 5 when the chyme is too thick or if The Insides® Pump is blocked.

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