Scintigraphic Assessment of Retrograde Colonic Washout in Fecal Incontinence and Constipation

Christensen, Peter; Olsen, Niels Vidiendal; Krogh, Klaus; Bacher, Theis; Laurberg, S

doi:10.1007/s10350-004-6498-0

Cited by 67 publications

(54 citation statements)

References 26 publications

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“…Apart from one single centre study, 15 most publications have looked at subjective symptomatic outcome data. The results of this study have provided some validation for the subsequent use of symptom scores.…”

Section: Discussionmentioning

confidence: 99%

“…By regularly emptying the bowel in this manner, TAI is intended to help re-establish controlled bowel function and enable the user to choose the time and place of evacuation. In patients with faecal incontinence, efficient emptying of the colon and rectum means that new faeces do not reach the rectum for B2 days, 15 thereby preventing leakage between irrigations. In patients with constipation, regular evacuation of the rectosigmoid region can promote transport through the entire colon and therefore prevent blockages.…”

Section: Introductionmentioning

confidence: 99%

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Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Emmanuel

2010

Spinal Cord

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Study design: Neurogenic bowel dysfunction (NBD) is a common occurrence after spinal cord injury (SCI) and in patients with spina bifida or multiple sclerosis. The impact of NBD on well-being is considerable, affecting both physical and psychological aspects of quality of life. Transanal irrigation (TAI) of the colon promotes the evacuation of faeces by introducing water into the colon and rectum through a catheter inserted into the anus. Regular and controlled evacuation in this manner aims at preventing both constipation and faecal soiling. Objectives: The aim of this study was to review current evidence for the efficacy and safety of TAI in patients with NBD. Materials and methods: A literature search was conducted in PubMed. All identified papers were assessed for relevance based on the title and abstract; this yielded 23 studies that were considered to be of direct relevance to the topic of the review. Results: A multicentre, randomized, controlled trial has supported observational reports in demonstrating that TAI offers significant benefits over conservative bowel management in patients with SCI, in terms of managing constipation and faecal incontinence, reducing NBD symptoms and improving quality of life. Among other populations with NBD, TAI shows the greatest promise in children with spina bifida; however, further investigation is required. The overall safety profile of TAI is good, with few, and rare, adverse effects. Conclusions: Building on the positive data reported for patients with SCI, continued evaluation in the clinical trial setting is required to further define the utility of TAI in other populations with NBD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Emmanuel

2010

Spinal Cord

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“…Two other groups [19][20][21][22][23] reported their results with RCI. A Japanese group [19] introduced RCI first successfully in 10 patients with evacuation after a lower anterior resection with defecation problems.…”

Section: Discussionmentioning

confidence: 99%

Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

Cazemier¹,

Felt‐Bersma²,

Mulder³

2007

WJG

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AIM:To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation (RCI) in patients with fecal incontinence or constipation. METHODS:Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire. RESULTS:Of the 201 patients (93 adults, 108 children), 101 (50%) responded. Adults: anal plugs (8), five stopped immediately, one stopped after 20 mo and two used it for 12-15 mo. RCI (40, 28 fecal incontinence, 12 constipation), 63% are still using it (mean 8.5 years), 88% was satisfied. Younger adults (< 40 years) were more satisfied with RCI (94 % vs 65%, P = 0.05).Children: anal plugs (7), 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI (26 fecal incontinence, 22 constipation), 90% are still using it (mean time 6.8 years) and felt satisfied. Children tend to be more satisfied (P = 0.001). Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation. CONCLUSION:RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.

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“…These patients may suffer from constipation, fecal incontinence or both. [1][2][3][4][5] While urological sequelae and their treatment are well documented, 6,7 neurogenic bowel dysfunctions (NBD) are among the least discussed topics in the literature, perhaps because of the misperception that there is little serious morbidity or mortality associated with NBD. 8 For these reasons, treatment of NBD has been largely empirical and individual solutions have been sought.…”

Section: Introductionmentioning

confidence: 99%

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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Scintigraphic Assessment of Retrograde Colonic Washout in Fecal Incontinence and Constipation

Abstract: The effect of retrograde colonic washout was significantly better in spinal cord lesion and idiopathic fecal incontinence than in idiopathic constipation, and its effect correlated with the extent to which the irrigation fluid had entered the colorectum.

Cited by 67 publications

References 26 publications

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Review of the efficacy and safety of transanal irrigation for neurogenic bowel dysfunction

Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

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

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