Cargando…

Long-Term Outcomes of Transanal Irrigation for Bowel Dysfunction

Introduction: Transanal irrigation (TAI) improves bowel function and quality of life in patients with neurogenic bowel disease compared to conservative bowel care. Its use has been extended to a range of defecatory disorders. However, data on long-term benefits and compliance are lacking. We aim to...

Descripción completa

Detalles Bibliográficos
Autores principales: Tamvakeras, Panagiotis, Horrobin, Clare, Chang, Jessica, Chapman, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10371390/
https://www.ncbi.nlm.nih.gov/pubmed/37502470
http://dx.doi.org/10.7759/cureus.42507
_version_ 1785078137303859200
author Tamvakeras, Panagiotis
Horrobin, Clare
Chang, Jessica
Chapman, Mark
author_facet Tamvakeras, Panagiotis
Horrobin, Clare
Chang, Jessica
Chapman, Mark
author_sort Tamvakeras, Panagiotis
collection PubMed
description Introduction: Transanal irrigation (TAI) improves bowel function and quality of life in patients with neurogenic bowel disease compared to conservative bowel care. Its use has been extended to a range of defecatory disorders. However, data on long-term benefits and compliance are lacking. We aim to evaluate the long-term efficacy of TAI by examining compliance and patient outcomes over a five-year period. Methods: This study is a five-year retrospective review of patients practising TAI in a district general hospital. Patient demographics, indications, long-term compliance, adverse events, and patient-reported Qufora bowel symptom bother scores were analysed. Results: A cohort of 18 patients had a median age of 61 (range 23-91) and were predominantly female (83.5%). The reasons for bowel dysfunction were diverse: low anterior resection syndrome, neurogenic bowel, congenital anorectal malformations, obstructed defecation, and functional disorders. Predominant symptoms were constipation (9), faecal incontinence (7), and mixed (2). Both high-volume (catheter and cone) and low-volume (mini cone) irrigation devices were used. Fourteen patients continued regular irrigation at a median follow-up of 27.7 months (range 5.1-72.3), while four had discontinued at a median follow-up of 4.8 months. The reasons for discontinuation were inadequate rectal evacuation and spontaneous improvement of symptoms. In the compliant group, there was a significant improvement in bowel symptom scores (p=0.003). No major adverse events, such as significant rectal bleeding or perforation, were noted. Conclusion: In this small cohort, TAI was safe and effective for long-term use; however, a fifth of patients discontinued treatment. Further work needs to be done to identify those patients who will benefit from TAI.
format Online
Article
Text
id pubmed-10371390
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-103713902023-07-27 Long-Term Outcomes of Transanal Irrigation for Bowel Dysfunction Tamvakeras, Panagiotis Horrobin, Clare Chang, Jessica Chapman, Mark Cureus Gastroenterology Introduction: Transanal irrigation (TAI) improves bowel function and quality of life in patients with neurogenic bowel disease compared to conservative bowel care. Its use has been extended to a range of defecatory disorders. However, data on long-term benefits and compliance are lacking. We aim to evaluate the long-term efficacy of TAI by examining compliance and patient outcomes over a five-year period. Methods: This study is a five-year retrospective review of patients practising TAI in a district general hospital. Patient demographics, indications, long-term compliance, adverse events, and patient-reported Qufora bowel symptom bother scores were analysed. Results: A cohort of 18 patients had a median age of 61 (range 23-91) and were predominantly female (83.5%). The reasons for bowel dysfunction were diverse: low anterior resection syndrome, neurogenic bowel, congenital anorectal malformations, obstructed defecation, and functional disorders. Predominant symptoms were constipation (9), faecal incontinence (7), and mixed (2). Both high-volume (catheter and cone) and low-volume (mini cone) irrigation devices were used. Fourteen patients continued regular irrigation at a median follow-up of 27.7 months (range 5.1-72.3), while four had discontinued at a median follow-up of 4.8 months. The reasons for discontinuation were inadequate rectal evacuation and spontaneous improvement of symptoms. In the compliant group, there was a significant improvement in bowel symptom scores (p=0.003). No major adverse events, such as significant rectal bleeding or perforation, were noted. Conclusion: In this small cohort, TAI was safe and effective for long-term use; however, a fifth of patients discontinued treatment. Further work needs to be done to identify those patients who will benefit from TAI. Cureus 2023-07-26 /pmc/articles/PMC10371390/ /pubmed/37502470 http://dx.doi.org/10.7759/cureus.42507 Text en Copyright © 2023, Tamvakeras et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Gastroenterology
Tamvakeras, Panagiotis
Horrobin, Clare
Chang, Jessica
Chapman, Mark
Long-Term Outcomes of Transanal Irrigation for Bowel Dysfunction
title Long-Term Outcomes of Transanal Irrigation for Bowel Dysfunction
title_full Long-Term Outcomes of Transanal Irrigation for Bowel Dysfunction
title_fullStr Long-Term Outcomes of Transanal Irrigation for Bowel Dysfunction
title_full_unstemmed Long-Term Outcomes of Transanal Irrigation for Bowel Dysfunction
title_short Long-Term Outcomes of Transanal Irrigation for Bowel Dysfunction
title_sort long-term outcomes of transanal irrigation for bowel dysfunction
topic Gastroenterology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10371390/
https://www.ncbi.nlm.nih.gov/pubmed/37502470
http://dx.doi.org/10.7759/cureus.42507
work_keys_str_mv AT tamvakeraspanagiotis longtermoutcomesoftransanalirrigationforboweldysfunction
AT horrobinclare longtermoutcomesoftransanalirrigationforboweldysfunction
AT changjessica longtermoutcomesoftransanalirrigationforboweldysfunction
AT chapmanmark longtermoutcomesoftransanalirrigationforboweldysfunction