Transanal irrigation
 | This article may be in need of reorganization to comply with Wikipedia's layout guidelines. (June 2014) |
| Transanal irrigation | |
|---|---|
| Specialty | gastroenterology |
Transanal irrigation (TAI, also termed retrograde irrigation)[nb 1] of the rectum and colon is designed to assist the evacuation of feces from the bowel by introducing water into these compartments via the anus.[1]
It is a treatment for persons with bowel dysfunction, including fecal incontinence and/or constipation (especially obstructed defecation). The impact of transanal irrigation varies considerably. Some individuals experience complete control of incontinence, and other report little or no benefit.[1] Evidence show this treatment can be considered for children as well.[2][3]
When diet and medication has proven ineffective, transanal irrigation is used.[1][4]
Advantages and disadvantages
Possible advantages:
- Avoids surgery, medications, or other procedures[5]
- By regularly emptying the bowel using transanal irrigation, controlled bowel function is often re-established to a high degree in patients with bowel dysfunction. This enables the users to develop a consistent bowel routine by choosing the time and place of evacuation.[1]
- In patients with constipation, regular evacuation of the lower part of colon and rectum can accelerate transit through the entire colon.[6] There has, perhaps unsurprisingly, been a rapid uptake of transanal irrigation methods in highly symptomatic patient groups with anorectal symptoms.[7][non-primary source needed]
- In individuals with fecal incontinence, efficient emptying of the lower part of colon and rectum means that new feces may not reach the rectum for up to 2 days, which may prevent leakage between irrigations.[8][non-primary source needed]
- May decrease the incidence of urinary tract infections in patients with neurogenic bowel and bladder problems[9]
Possible disadvantages:
- Requires training by a healthcare professional so individual understands how to use the equipment
- A degree of dexterity is required to perform transanal irrigation at home. If the individual cannot perform the irrigation themselves, a carer may be required
- Periodic replacement of the equipment is needed, or microbial biofilms may start grow inside the tubing, contaminating the irrigation fluid. Current TAI devices offer single-use rectal catheters or cones.
- Persistent leaking of residual irrigation fluid after the irrigation may occur and make this option unhelpful as liquids are more difficult to retain than solids in persons with fecal incontinence.[10]
- Complications such as perforation (very rare).[11]
Notes
- ^ The term retrograde irrigation distinguishes this procedure from the Malone antegrade continence enema, where irrigation fluid is introduced into the colon proximal to the anus via a surgically created irrigation port