What is bowel irrigation?
Transanal irrigation (TAI) is a well-documented bowel emptying technique that is effective at preventing fecal incontinence and chronic constipation.
The drainage time is individual, but on average it takes 30 minutes and leaves the bowel clean and empty for up to 2 days.
What happens if bowel irrigation is not done regularly?
If irrigation is not done regularly, you may feel uncomfortable and may experience:
- Constipation – this can result in abdominal pain, bloating, cramping and may decrease your appetite.
- Leakage of stool – this happens when the bowel is not fully emptied.
When you start bowel irrigation, it is a good idea to keep a diary of your bowel movements. Recording when you irrigate, how much water you use and the results achieved can help you build a better bowel management routine. Find a bowel diary here.
How often should you irrigate?
Your physician will determine how often you need to use the Peristeen Plus system. Get into a routine where you irrigate around the same time of the day. Eating and drinking stimulates the bowel, so irrigating 30 minutes after a meal is recommended for the natural activity of the bowel. The most important thing is that you continue to be patient and stick to your routine. Flexibility and consistency are key.
Start a regular bowel irrigation routine as prescribed by your physician and stick to it! Be patient during the learning curve.
How can I keep track of the number of times I use the product?
A usage calendar can be useful to track the frequency of irrigations. It will help you know when to replace different parts of the system. A copy can be downloaded here.
How much water should I use?
The required amount of water is specific to each individual and your doctor or nurse will tell you how much water to use. If your provider recommends a range, follow their advice for increasing the water and keep track of your results in the bowel diary.
Why is the temperature of the water important?
The water should be lukewarm (93-104°F), with body temperature of 98.6°F being optimal. Water that is too hot may harm the delicate lining of the bowel. Water that is too cold may cause stomach cramps. The water temperature indicator on the Peristeen Plus water bags will be green when the temperature is within the suitable range for irrigation. If in doubt, or unable to distinguish the colors, run the water over your wrist to feel if it is lukewarm.
Can I travel with the bowel irrigation equipment?
Yes. Remember to bring your Peristeen Plus system and sufficient number of rectal balloon catheters, depending on how long you will be away and how often you irrigate. Regular tap water is usually fine but if you do not have access to clean tap water, then use bottled water. In general, if the water is safe to drink, it can be used for your irrigation.
Remember in different time zones your body may take a while to get used to a new routine. You may also be eating different types of food, which can affect the bowel.
Should I be concerned if I experience discomfort, sweating and/or dizziness during irrigation?
Pause the irrigation. Turn the knob on the control unit to the white balloon symbol to stop the water flow and wait until the discomfort ceases. When you are ready, turn the knob on the control unit back to the turquoise water symbol and resume pumping. If the discomfort is severe or does not resolve, urgent medical assessment is necessary. Consider the possibility of autonomic dysreflexia or bowel perforation.
What if I experience abdominal cramps?
Check that the irrigation water is not too cold; it should be lukewarm (93-104°F), with the water temperature indicator at green. Try pumping the water more slowly and/or pause for a minute and wait until the cramping eases. You may also try waiting 20-30 minutes after meals to make sure your stomach is not full.
Remember that cramps should never be intense or painful. If this is the case, you need to contact your healthcare professional immediately.
What if the catheter comes out during pumping?
If the catheter comes out and the balloon is deflated, check for a burst balloon.
If the balloon comes out immediately after inflation, it is probably causing the anus to contract. Try inflating the balloon more slowly or inflate it a little less.
If the balloon comes out while you are pumping, check that the irrigation water is not too cold; it should be at body temperature. Also try pumping the water more slowly. Even though it is recommended to irrigate 30 minutes after a meal, the balloon may be more likely to come out if bowel irrigation is performed after a meal. If this happens, try another time of day.
Contact your provider who may be able to help you either rule out heavy constipation or impaction, or treat accordingly before resuming irrigation.
How quickly should I pump the water?
If the water is pumped too quickly into the bowel, you may experience discomfort such as sweating, dizziness or stomach pains.
What if nothing happens?
Check how much you have been drinking. It is usually recommended that people drink at least 6-8 cups of liquid a day, more in hot weather unless otherwise indicated by your health care professional. Call your Coloplast® Care Advisor at 1-855-605-7594 for additional support.
There’s water but no stool?
You could be heavily constipated, in which case the blockage should be cleared before repeating irrigation; a laxative may be required. If irrigation had good results previously, there may be no stool present and the frequency of irrigation may need to be adjusted. Speak with your healthcare professional before making any changes to your prescribed routine.
I am leaking water or stool after bowel irrigation
Stand, wiggle, sit down again and brace (lean forward); 30-60 minutes after irrigating – return to toilet and brace. Try using more or less water, or repeating the irrigation twice using half the volume of water each time. For neurogenic patients try digital stimulation after emptying.
What if I experience defecation between irrigations?
Consult your clinician to see if the frequency of your irrigations or amount of water used for irrigations may need to be adjusted.
Can I stop the irrigation if I want a break?
In case of discomfort and you feel the need for a break, stop the water flow and wait until the discomfort ceases. When you are ready, resume pumping. If the discomfort does not disappear, contact your healthcare professional immediately.