For most people, emptying the bowel is not a problem. However, some people experience faecal incontinence, constipation, or other bowel management difficulties – which can lead to anxiety, depression, and social isolation. Rectal irrigation can help to relieve these problems and enable people to live a full and happy life again – free from the worry of ‘accidents’ or constipation.
Bowel problems can be experienced as abdominal pain, spasms, bloating, flatus, inability to defaecate or pass flatus, loose and watery stools, sensation of constipation, diarrhoea, vomiting and weight loss. Bowel dysfunction can result in rectal bleeding, haemorrhoids, rectal prolapse, anal fissures or skin ulcers.
Bowel problems can be treated using conservative bowel management, such as diet and liquid regulation, regular exercise, use of laxatives or constipation medication, digital stimulation or manual evacuation, and even surgical options such as a colostomy. However, sometimes conservative bowel management does not solve a problem, and inadequate bowel management can have a devastating impact on day-to-day living and quality of life.
Rectal irrigation (sometimes called anal irrigation or trans-anal irrigation) has been practiced for many centuries, but has become more widely used by doctors in recent years. It involves instilling warm tap water into the rectum via the anus and then allowing the water to be expelled, thus emptying the colon. Quick, effective, and hygienic, rectal irrigation is a reliable method for bowel management that improves quality of life, dignity, and self esteem.
Who can it help?
Rectal irrigation can help:
- People with neurogenic diseases or injuries (e.g., spinal cord injuries, multiple sclerosis)
- People with chronic faecal incontinence
- People with chronic constipation
- Elderly people who are immobile or bed confined for long periods of time
Is it safe?
Rectal irrigation is safe as long as you follow a few simple rules:
- A qualified healthcare professional should undertake a thorough bowel assessment before any patient starts on an irrigation routine. The healthcare professional should be present, at least when the patient performs the first irrigation, to make sure the process is understood and completed properly.
- Always follow instructions. This will reduce the risk of bowel perforation – which, although rare, is a potential complication of performing irrigation. If bowel perforation occurs, seek medical attention immediately.
- You may need to modify the amount of water used and the frequency of irrigation to achieve the optimal routine.
- Please note that minor side effects can occur, including minor abdominal pain, nausea, light bleeding, and fatigue.
Tips for irrigation success
- Irrigate regularly: rectal irrigation should be performed regularly (usually daily or every other day) to achieve full continence and prevent constipation.
- Have patience: it will take time – 4 to 8 weeks or even longer – to develop the best irrigation routine for you.
- Irrigate daily: always start irrigation on a daily basis. Once the process is working, you can try to reduce frequency if you’re comfortable with this and if it continues to produce the desired result.
- Develop a good routine: try to develop a routine where you irrigate at a time of day that works for you.
- Drink plenty of water: always make sure to drink the correct amount of water. If your water balance is too low, irrigation water can be retained and absorbed by the bowel.