Transanal irrigation bowel routine for people with Cauda Equina Syndrome

The Functional Implications of Transanal Irrigation: Insights from Pathophysiology and Clinical Studies of Neurogenic Bowel Dysfunction

“…Balloon inflation is necessary to retain intracolonic content and deflation supports the stool evacuation function. The device facilitates pressurized water that is introduced into the colon via the rectum; the water is retained by sealing the outflow with the inflated balloon, leading to the activation of intact stretch receptors and intrinsic sensory nerves in the colonic wall and the stimulation of the intact intrinsic neuromuscular apparatus to stimulate peristalsis, propelling the colon contents distally [ 58 , 65 ]. In parallel, the rectal catheter stretches the rectum and activates RAIR (whether its amplitude is high or low), relaxing the IAS to facilitate evacuation when the balloon is deflated and the mechanical obstruction is removed [ 36 ].…”

“…A clinical study by Ethans et al supports the proposed MOA. Ethans et al determined an improved colonic transit time using a Metcalf (radiopaque marker transit) method after administering TAI with a rectal balloon catheter [ 65 ]. In their study, colonic transit time improved by 22% (from mean 84.1 h at baseline to mean 65.4 h at follow-up) after using TAI for 10 weeks in individuals with cauda equina syndrome (CES).…”