Transanal irrigation to treat bowel dysfunction: an update on practice

Transanal irrigation (TAI) has been receiving increasing attention and acceptance in recent years as a treatment option for bowel dysfunction, including chronic constipation, faecal incontinence, neurogenic bowel disorders and lower anterior resection syndrome. TAI involves the instillation of tepid water into the bowel via a rectal catheter or cone to achieve a controlled bowel cleanout. This article addresses the competencies that health professionals require to use TAI. Prior to instigating TAI, these include how to undertake an adequate bowel assessment; understand the risks and complications associated with TAI; and select the equipment most suitable for an individual's bowel symptoms. The professional must also be able to instruct the user in how to safely perform the procedure; discuss contra-indications and cautions; and collect outcome measures, including reasons for discontinuation.

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Transanal Irrigation for Neurogenic Bowel Disease, Low Anterior Resection Syndrome, Faecal Incontinence and Chronic Constipation: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10040753 ◽

2021 ◽

Vol 10 (4) ◽

pp. 753

Author(s):

Mira Mekhael ◽

Helle Ø Kristensen ◽

Helene Mathilde Larsen ◽

Therese Juul ◽

Anton Emmanuel ◽

...

Keyword(s):

Systematic Review ◽

Predictive Factors ◽

Anterior Resection ◽

Chronic Constipation ◽

Low Anterior Resection ◽

Bowel Function ◽

Bowel Dysfunction ◽

Successful Outcome ◽

Low Anterior Resection Syndrome ◽

Neurogenic Bowel

Transanal irrigation (TAI) has received increasing attention as a treatment option in patients with bowel dysfunction. This systematic review was conducted according to the PRISMA guidelines and evaluates the effect of TAI in neurogenic bowel dysfunction (NBD), low anterior resection syndrome (LARS), faecal incontinence (FI) and chronic constipation (CC). The primary outcome was the effect of TAI on bowel function. Secondary outcomes included details on TAI, quality of life (QoL), the discontinuation rate, adverse events, predictive factors for a successful outcome, and health economics. A systematic search for articles reporting original data on the effect of TAI on bowel function was performed, and 27 eligible studies including 1435 individuals were included. Three randomised controlled trials, one non-randomised trial, and 23 observational studies were included; 70% of the studies were assessed to be of excellent or good methodological quality. Results showed an improvement in bowel function among patients with NBD, LARS, FI, and CC with some studies showing improvement in QoL. However, discontinuation rates were high. Side effects were common, but equally prevalent among comparative treatments. No consistent predictive factors for a successful outcome were identified. Results from this review show that TAI improves bowel function and potentially QoL; however, evidence remains limited.

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Transanal irrigation in lower anterior resection syndrome (LARS): a case study

Gastrointestinal Nursing ◽

10.12968/gasn.2018.16.8.24 ◽

2018 ◽

Vol 16 (8) ◽

pp. 24-26

Author(s):

Amanda Eccles

Keyword(s):

Anterior Resection ◽

Anterior Resection Syndrome ◽

Transanal Irrigation ◽

Lower Anterior Resection

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Long-Term Cost-Effectiveness of Transanal Irrigation In Patients With Neurogenic Bowel Dysfunction Who Have Failed Standard Bowel Care

Value in Health ◽

10.1016/j.jval.2015.09.691 ◽

2015 ◽

Vol 18 (7) ◽

pp. A360 ◽

Cited By ~ 3

Author(s):

A Emmanuel ◽

P Christensen ◽

G Kumar ◽

V Passananti ◽

S Mealing ◽

...

Keyword(s):

Cost Effectiveness ◽

Bowel Dysfunction ◽

Transanal Irrigation ◽

Neurogenic Bowel

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Development of a decision guide for transanal irrigation in bowel disorders

Gastrointestinal Nursing ◽

10.12968/gasn.2019.17.7.24 ◽

2019 ◽

Vol 17 (7) ◽

pp. 24-30 ◽

Cited By ~ 3

Author(s):

Anton Emmanuel ◽

Brigitte Collins ◽

Michelle Henderson ◽

Lisa Lewis ◽

Kelly Stackhouse

Keyword(s):

Patient Education ◽

Best Practice ◽

Healthcare Providers ◽

Working Party ◽

Bowel Function ◽

Bowel Dysfunction ◽

Optimal Decisions ◽

Transanal Irrigation ◽

Bowel Disorders

Transanal irrigation (TAI), which has emerged as a therapy for patients with bowel dysfunction, can aid emptying of the bowel and help to re-establish control of bowel function by choosing the time and place of evacuation. Because of the ever-growing numbers of TAI systems available, choosing the optimal equipment can be overwhelming. Therefore, a consensus review of best practice from a working party of experts was thought to represent the most appropriate means of arriving at clinically meaningful advice. This led to the production of an article as well as a decision-guide booklet to aid choice of equipment, initiation, patient education, regimen setting and follow-up. These are designed to help healthcare providers initiating TAI to make optimal decisions for each individual patient.

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Transanal irrigation: is it the magic intervention for bowel management in individuals with bowel dysfunction?

British Journal of Nursing ◽

10.12968/bjon.2020.29.7.393 ◽

2020 ◽

Vol 29 (7) ◽

pp. 393-398

Author(s):

Ann Yates

Keyword(s):

Health Professional ◽

Faecal Incontinence ◽

Alternative Therapy ◽

Bowel Dysfunction ◽

Colonic Irrigation ◽

Bowel Motility ◽

Transanal Irrigation ◽

Transit Times ◽

Bowel Disorders ◽

Slow Transit

Historically, the use of colonic irrigation or transanal irrigation (TAI) has been viewed as an alternative therapy for the treatment of a wide variety of conditions not relating to bowel dysfunction, including nausea, fatigue, depression, headache, anxiety and rheumatism. However, these days it is viewed as an effective treatment in individuals who may present with bowel dysfunction and related symptoms of constipation and faecal incontinence. Such individuals would include people with neuropathic bowel disorders, conditions that affect sphincter control or bowel motility disorders. injury to the rectum, sphincter or bowel, slow transit times, evacuation difficulties or prolapse due to a weak/damaged pelvic floor, and chronic faecal incontinence. TAI may be performed by the person with bowel dysfunction, or by a carer or health professional. An individual's ability to use a device to undertake the procedure will be influenced by a range of factors, which are explored in this article.

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