An overview of transanal irrigation devices: an update
Transanal irrigation (TAI) is safe and effective treatment for constipation and faecal incontinence, but it should not be carried out before less invasive options have been tried. A thorough patient assessment and consideration of their preferences and tolerance should determine suitability and system choice. The range of available TAI equipment can be overwhelming. Therefore, to aid health professionals, this article presents a summary of the latest available devices on the market, as well as guidance on how to select a suitable device. TAI devices can be categorised into low-or high-volume; cones, catheters or balloon inflating devices; manual, electric pump or gravity-fed systems; and bed systems. Determining whether a low or high volume of water is required is a good starting point for device selection. Nurses should be aware of available devices and select one most suitable for a patient, as well as adequately train them in its usage and provide follow-up support. Nurses should communicate the potential improvement to quality of life TAI can offer and encourage adherence to avoid premature discontinuation.
Approximately 6.5 million adults in the UK suffer from a bowel problem and over half a million adults suffer from faecal incontinence (NHS England, 2018). Transanal irrigation (TAI) is widely used to manage neurogenic bowel dysfunction (NBD) and has been approved by the National Institute for Health and Care Excellence (NICE) (2018) as a treatment for constipation and faecal incontinence. It is a maintenance therapy, rather than a cure (Emmett et al, 2017).
TAI involves instilling water into the lower bowel via the anus using either a rectal catheter or a cone, and is usually performed over a toilet. When the catheter or cone is removed, the water is expelled along with the contents of the rectum, sigmoid colon and possibly the descending colon (Nursing Times, 2007). Following sufficient training, TAI can be performed by the patient, a carer or a health professional (Yates, 2020).
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