A Randomized, Controlled Trial of Transanal Irrigation Versus Conservative Bowel Management in Spinal Cord–Injured Patients

Christensen, Peter; Bazzocchi, Gabriele; Coggrave, Maureen; Abel, Rainer; Hultling, Claes; Krogh, Klaus; Media, Shwan Kader; Laurberg, Søren

doi:10.1053/j.gastro.2006.06.004

Cited by 242 publications

(269 citation statements)

References 40 publications

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“…In all, 28.6% of patients reduced or eliminated their use of pharmaceuticals. 18 When asked about symptoms in connection with evacuation, there was a net increase in the answers 'never' and 'rarely' in the before-and-after evaluation (P ¼ 0.001), as the feeling of incomplete evacuation was found to be considerably decreased. Abdominal pain or discomfort before or after evacuation was also reduced (P ¼ 0.001).…”

Section: Resultsmentioning

confidence: 96%

“…In a recent trial using the Peristeen Anal Irrigation System, a successful outcome was reported for 73% of patients regarding fecal incontinence and 40% of patients regarding constipation. 18 Difficulties with catheter introduction, expulsion of catheter, leakage and burst of balloon were reduced with the Peristeen Anal Irrigation System. 18 The ease of manual handling of the pump, control unit and irrigation system effectively increased the independence of patients.…”

Section: Discussionmentioning

confidence: 99%

“…18 Difficulties with catheter introduction, expulsion of catheter, leakage and burst of balloon were reduced with the Peristeen Anal Irrigation System. 18 The ease of manual handling of the pump, control unit and irrigation system effectively increased the independence of patients. Therefore, using the Peristeen Anal Irrigation System improved intestinal functioning and increased QoL in the opinion of the majority of the patients who took part in the study; at a minimum follow-up of 6 months after the end of the study, 39.3% of patients had a high level of physical acceptance of the self-administered transanal irrigation system, were extremely satisfied and preferred to use the self-administered transanal irrigation system rather than previous bowel emptying habits.…”

Section: Discussionmentioning

confidence: 99%

“…The Peristeen Anal Irrigation System (Coloplast A/S Kokkedal, Denmark) was used for NBD treatment. 18 The system comprises a coated rectal balloon catheter, manual pump, pressure control unit and water container (Figure 1). The catheter is inserted into the rectum and the balloon inflated to hold the catheter in the rectum while a tap water enema is slowly administered with the manual pump.…”

Section: Methodsmentioning

confidence: 99%

“…17 However, a recent randomized controlled trial found that patients treated with the Peristeen Anal Irrigation System (Coloplast A/S, Kokkedal, Denmark) had fewer complaints of constipation, less fecal incontinence, improved symptom-related QoL and reduced time consumption on bowel management procedures compared with patients treated by conservative bowel management. 18 The Peristeen Anal Irrigation System is specially designed to ease bowel irrigation in spinal cord-injured patients. The irrigation procedure can be done without assistance from another person, even by immobilized patients and patients with poor hand function.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of neurogenic bowel dysfunction using transanal irrigation: a multicenter Italian study

et al. 2008

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Study design: Thirty-six patients with unsatisfactory treatment of neurogenic bowel dysfunctions (NBD) were enrolled from Spinal Units and Rehabilitation Centers in Italy. Treatment was for 3 weeks using a newly developed integrated system with an enema continence catheter for transanal irrigation (Peristeen, Coloplast A/S Kokkedal Denmark). Objectives: To evaluate the effects of Peristeen Anal Irrigation on NBD and patient quality of life (QoL). Setting: Italy. Methods: Lesion level, ambulatory status and hand functionality were determined in all patients. NBD symptoms and QoL were evaluated before and after treatment, using a specific questionnaire. Statistical analysis was performed using McNemar Test and Sign Test. Results: Thirty-six patients were enrolled, and 32 patients completed the study. At the end of the treatment, 28.6% of patients reduced or eliminated their use of pharmaceuticals. Twenty-four patients became less dependent on their caregiver. There was a significant increase in patients' opinion of their intestinal functionality (P ¼ 0.001), QoL score (P ¼ 0.001) and their answers regarding their degree of satisfaction (P ¼ 0.001). A successful outcome was recorded for 68% of patients with fecal incontinence, and for 63% of patients with constipation. Conclusion: Peristeen Anal Irrigation is a simple therapeutic method for managing NBD and improving QoL. It should be considered as the treatment of choice for NBD, playing a role in the neurogenic bowel analogous to that of intermittent clean catheterization in bladder treatment.

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Section: Resultsmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of neurogenic bowel dysfunction using transanal irrigation: a multicenter Italian study

et al. 2008

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Management of faecal incontinence and constipation in adults with central neurological diseases

Coggrave¹,

Norton²

2013

Cochrane Database of Systematic Reviews

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Management of faecal incontinence and constipation in adults with central neurological diseases

Coggrave

Norton

Cody

2014

Cochrane Database of Systematic Reviews

150

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BackgroundPeople with central neurological disease or injury have a much higher risk of both faecal incontinence and constipation than the general population. There is often a fine line between the two symptoms, with any management intended to ameliorate one risking precipitating the other. Bowel problems are observed to be the cause of much anxiety and may reduce quality of life in these people. Current bowel management is largely empirical, with a limited research base. This is an update of a Cochrane review first published in 2001 and subsequently updated in 2003 and 2006. The review is relevant to individuals with any disease directly and chronically affecting the central nervous system (post-traumatic, degenerative, ischaemic or neoplastic), such as multiple sclerosis, spinal cord injury, cerebrovascular disease, Parkinson's disease and Alzheimer's disease. ObjectivesTo determine the effects of management strategies for faecal incontinence and constipation in people with a neurological disease or injury affecting the central nervous system. Search methodsWe searched the Cochrane Incontinence Group Trials Register (searched 8 June 2012), which includes searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and MEDLINE In-Process as well as handsearching of journals and conference proceedings; and all reference lists of relevant articles. Selection criteriaRandomised and quasi-randomised trials evaluating any type of conservative or surgical intervention for the management of faecal incontinence and constipation in people with central neurological disease or injury were selected. Specific therapies for the treatment of neurological diseases that indirectly affect bowel dysfunction were also considered. Data collection and analysisAt least two review authors independently assessed the risk of bias of eligible trials and independently extracted data from the included trials using a range of pre-specified outcome measures. 1 Management of faecal incontinence and constipation in adults with central neurological diseases (Review)

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A Randomized, Controlled Trial of Transanal Irrigation Versus Conservative Bowel Management in Spinal Cord–Injured Patients

Cited by 242 publications

References 40 publications

Treatment of neurogenic bowel dysfunction using transanal irrigation: a multicenter Italian study

Treatment of neurogenic bowel dysfunction using transanal irrigation: a multicenter Italian study

Management of faecal incontinence and constipation in adults with central neurological diseases

Management of faecal incontinence and constipation in adults with central neurological diseases

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