WHAT IS RECTAL IRRIGATION?
Rectal irrigation is a system for flushing out the contents of the bowel. It can be extremely useful for patients who suffer from chronic constipation or faecal incontinence and wish to control bowel emptying at their own convenience and in privacy. Many patients find it improves their quality of life enormously.
HOW DOES IT WORK?
You carry out the treatment yourself, at home. Most patients find that irrigating every second day is sufficient.
Warm water is introduced into the rectum using special equipment. A small, soft tube is inserted into the rectum and a hand pump is used to gently introduce the water whilst you sit over the toilet.
This stimulates the bowel to contract, pushing out the contents through the rectum. Because it stimulates contractions through the bowel, the whole of the lower bowel empties. This minimises the risk of constipation or bowel accidents, allowing you to go about your daily activities comfortably and with more confidence.
It should not be uncomfortable or painful, and with practise it becomes quick and easy to use.
WHAT WILL HAPPEN AT MY APPOINTMENT?
Your first appointment with the specialist nurse will last about one hour. She will first ask you questions about your medical history to make sure that irrigation is suitable for you. She will then show you the different types of equipment and demonstrate how you should use them. Together you will decide which is the most suitable equipment for you. You will not use the equipment at the appointment, and you will not need to undress or have any examination.
The nurse will write to your GP and ask him or her to prescribe the equipment. All the manufacturers will deliver quickly and discreetly to your home address.
The nurse will phone you after three or four weeks to see how you are getting on and to answer any questions you may have. You will normally come back to clinic after three months for a final appointment to make sure that all is well and so that the nurse can help you to make any final adjustments to your irrigation routine.
WHAT ARE THE RISKS?
As long as instructions are carefully followed and you have a medical assessment before undertaking rectal irrigation, it is a very safe procedure.
There is a very small risk of perforating the bowel (1 in 500,000). Other minor complications can include a small amount of bleeding, pain, nausea and fatigue.
IS IT SUITABLE FOR ME?
Rectal irrigation is not suitable for patients who have:
- Acute active inflammatory bowel disease
- Obstructing rectal or colonic mass
- Rectal or colonic surgical anastomosis within the last six months
- Severe cognitive impairment (unless a carer can supervise or administer the treatment)
It may not be suitable for you if you have any of these conditions:
- Active perianal sepsis
- Anal fissure
- Large haemorrhoids that bleed easily
- Faecal impaction
- Past pelvic radiotherapy that has caused bowel symptoms
- Known severe diverticular disease
- Take rectal medication
- Congestive heart failure
- Anal surgery within the last six months.
If any of these apply to you, your Specialist Nurse will advise whether it is safe to use irrigation.
The following manufacturers’ websites provide more information which you may find helpful: