Christensen P, Krogh K, Perrouin-Verbe B Global audit on bowel perforations related to trans anal irrigation. Tech Coloproctol. 2016; 20:(2)109-115

Emmanuel AV, Krogh K, Bazzocchi G Consensus review of best practice of transanal irrigation in adults. Spinal Cord. 2013; 51:(10)732-738

Emmett CD, Close HJ, Yiannakou Y, Mason JM. Trans-anal irrigation therapy to treat adult chronic functional constipation: systematic review and meta-analysis. BMC Gastroenterol. 2015; 15:(1)

Etherson KJ, Minty I, Bain IM, Cundall J, Yiannakou Y. Transanal irrigation for refractory chronic idiopathic constipation: patients perceive a safe and effective therapy. Gastroenterology Research and Practice. 2017; 2017

Faaborg PM, Christensen P, Kvitsau B, Buntzen S, Laurberg S, Krogh K. Long-term outcome and safety of transanal colonic irrigation for neurogenic bowel dysfunction. Spinal Cord. 2009; 47:(7)545-549

Henderson M, Tinkler L, Yiannakou Y. Transanal irrigation as a treatment for bowel dysfunction. Gastrointestinal Nursing. 2018; 16:(4)26-34

National Institute for Health and Care Excellence. Peristeen Plus transanal irrigation system for managing bowel dysfunction. NICE Medical Technologies Guidance MTG36. 2022. https// (accessed 12 October 2023)

Spinal Injuries Association. Body matters: Autonomic dysreflexia. 2022. https// (accessed 17 October 2022)

Royal National Orthopaedic Hospital NHS Trust. Autonomic dysreflexia. 2023. https// (accessed 17 October 2023)

Yates A. Transanal irrigation: an alternative therapy for bowel dysfunction?. Br J Nurs. 2019; 28:(7)426-428

Transanal irrigation to treat chronic constipation in patients with spinal cord injury: a case study

26 October 2023
Volume 32 · Issue 19


This case study explores the benefits of transanal irrigation as a treatment for a patient with a spinal cord injury who was experiencing chronic constipation. In this case, the patient was having episodes of autonomic dysreflexia as a result of the constipation. This condition is unique to patients with spinal cord injury and presents a stroke risk. The article outlines the contraindications and cautions that need to be considered in assessing a patient's suitability for transanal irrigation, and the elements that form part of a holistic assessment by a specialist nurse.

Transanal irrigation is a conservative bowel management treatment for constipation that allows washout of the lower bowel, descending colon (up to the splenic flexure), and is used as an alternative to surgery (Yates, 2019). Instillation of warm or tepid tap water at 36–38°C (Henderson et al, 2018) produces rectal distension and is thought to stimulate peristalsis, which can greatly improve the symptoms and reduce the severity of chronic constipation. It is self-administered by the patient at home, or by carers, family members or community nursing teams after adequate training in the use of equipment designed for this purpose. It is minimally invasive, safe and effective in the management of chronic constipation.

Definitions of chronic constipation vary. To some, the term ‘chronic constipation’ means infrequent bowel movements for prolonged periods of time, often weeks, whereas to others it means experiencing straining or difficulty in evacuating the stool for at least 3 months (Emmett et al, 2015).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content