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Meeting personal needs: elimination
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Transanal irrigation can reduce the severity of constipation and incontinence. However, it may not be ideal for all types of bowel dysfunction and may take a few weeks for a person to become comfortable using this treatment. Fluid is introduced into the rectum and sigmoid colon via a rectal tube and pump device such as Peristeen® that washes out all faecal matter when the fluid is drained out. NICE (2018b) recommends this as an option when offered with specialist training and support and when effective can improve quality of life and promote dignity and independence.
Follow-Up and Post-Operative Sequelae in Colorectal Cancer
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Søren Laurberg, Peter Christensen
Following endoscopy to rule out luminal causes of symptoms, the majority of treatment initiatives for LARS can be undertaken by a nurse-led clinic.47 Initial treatment of LARS is with dietary advice and medical treatment to improve bowel consistency with laxatives or loperamide fibre supplements and evacuation assistance with the small-volume enemas, glycerol suppositories or rectal washouts.48 Bowel management may include pelvic floor exercises.49,50 Transanal irrigation improves rectal emptying, overcomes fragmented defaecation and protects against faecal incontinence.51 Some studies also have shown a beneficial effect of sacral nerve stimulation in LARS patients.52 With these measures only a few patients are referred for a permanent stoma47 (Figure 41.3).
Digital rectal stimulation as an intervention in persons with spinal cord injury and upper motor neuron neurogenic bowel. An evidenced-based systematic review of the literature
Published in The Journal of Spinal Cord Medicine, 2021
Mary Elizabeth S. Nelson, Merle Orr
Transanal irrigation was the primary intervention for two studies. The first study was the only randomized controlled study found on UMN-NB interventions. This study by Christensen et al.12 examined 87 patients with SCI and UMN-NB across five European countries. 25 female and 62 males were randomized to either transanal irrigation or conservative bowel management. Outcomes evaluated included multiple validated measures. Statistically significant results were found supporting transanal irrigation over conservative bowel management techniques on every outcome measured. Most significant were the outcomes on improvement in QOL (P = 0.000009), Cleveland Clinic constipation scoring system (P = 0.0016) and the bowel function score (P = 0.0048). The second study by Del Popolo et al.13 was of transanal irrigation for patients with SCI and UMN-NB. Thirty-three patients, 18 male and 15 female, served as their own controls and were evaluated pre and post-intervention. Use of the transanal irrigation system was correlated with a reduction in episodes of incontinence (P = 0.002), time until bowel evacuation (P = 0.004), QOL related to bowels (P = 0.001), and degree of satisfaction with bowel program (P = 0.001).
Management of Neurogenic Bowel Dysfunction in Adults after Spinal Cord Injury
Published in The Journal of Spinal Cord Medicine, 2021
Jeffery Johns, Klaus Krogh, Gianna M. Rodriguez, Janice Eng, Emily Haller, Malorie Heinen, Rafferty Laredo, Walter Longo, Wilda Montero-Colon, Catherine S. Wilson, Mark Korsten
What are the indications/contraindications/ complications/methods for digital rectal stimulation (DRS) for NBD after SCI?What are the indications/contraindications/ complications/methods for manual evacuation in the management of NBD after SCI?What are the indications/contraindications/ complications/methods for functional electrical stimulation (FES) in the management of NBD after SCI?What are the indications/contraindications/ complications/methods for functional magnetic stimulation in the management of NBD after SCI?What are the indications/contraindications/ complications/methods for abdominal massage in the management of NBD after SCI?What are the indications/contraindications/ complications/methods for transanal irrigation in the management of NBD after SCI?What are the indications/contraindications/ complications/methods for the Valsalva maneuver in the management of NBD after SCI?
Dietary management of neurogenic bowel in adults with spinal cord injury: an integrative review of literature
Published in Disability and Rehabilitation, 2021
Hiu Yan Yeung, Priya Iyer, Julie Pryor, Margaret Nicholson
Two studies investigated a bowel programme with an unspecified diet plan. One randomised controlled trial (n = 87) [27], compared Transanal Irrigation (TAI) with conservative bowel management that involved diet and fluid intake to modulate stool consistency. After treatment, bowel function, constipation, faecal incontinence, QoL, and satisfaction improved significantly in participants using TAI compared to those using conservative bowel management. Related study [28] compared the cost-effectiveness of the treatment and showed that TAI was more cost-effective. It is noteworthy to mention here that these were the only studies rated as having moderate quality of evidence with low risk of bias.