Understanding bowel irrigation

What is bowel irrigation?

Bowel irrigation (sometimes called trans-anal irrigation (TAI), rectal irrigation (RI) has been practiced for many hundreds of years. Over recent years it has been more widely used as a bowel management solution.

Bowel irrigation simply involves instilling warm tap water into the rectum via the anus and then allowing the water to be expelled, thus emptying the colon.

Use of bowel irrigation has shown that regular bowel irrigation can be an effective solution to prevent faecal incontinence and constipation. It can also reduce the amount of time spent on bowel management, improving quality of life, dignity, and self-esteem.

Bowel irrigation should be performed regularly (usually daily or every other day) to achieve full continence and prevent constipation1 . Bowel irrigation provides a reliable bowel management option, it is easy, quick, effective, and hygienic to use, allowing you to live life to the full and not worry about your bowels.

The difference between conservative bowel management and bowel irrigation

When using conservative methods of bowel management such as manual evacuation, only the distal part of the bowel is generally emptied (figure 1). 

When using bowel irrigation, the bowel has been shown to empty to the splenic flexure (the sharp bend between the ascending colon and the transverse colon), (figure 2).

Therefore, using warm water bowel irrigation can successfully empty your bowel so that a further irrigation does not have to take place for another 24-48 hours.2 

Reference: Christensen P et al. Scintigraphic assessment of retrograde colonic washout of faecal incontinence and constipation. DisColon Rectum 2003; 46:68-76

1 Reference: Christensens P, Colonic irrigation for disordered defecation, Doctoral thesis Aarhus University, 2009 

2 Reference: Shandling B & Gilmour RF 1987

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