Gastroenterology - Trans-Anal Irrigation (Rectal Irrigation)

This leaflet has 3 aims:

1. To help you become better informed and more involved in your care.
2. To explain what happens when you come for rectal irrigation.
3. To answer some of the questions commonly asked about the procedure.

If you have any questions, access or communication needs such as an interpreter please contact the department stated on your appointment letter.

Reasonable adjustments will be considered for all disabled users of this service.

Please make sure that you read the following information CAREFULLY.

Your doctor or other healthcare professional has referred you for Trans-Anal Irrigation, this is more commonly known as rectal irrigation. This is a procedure that you will do at home either by you or a carer if this is appropriate for you. It is a means of irrigating your bowel either to have a regular bowel action or to help prevent bowel accidents.

On receiving your referral for irrigation, we will either contact your GP or local Bladder and Bowel service with regards to prescribing irrigation for you. Once we have approval from your GP, we can then start irrigation training with you. If you live in an area where your local Bladder and Bowel team provide this service, we will refer you on to them, and you will be under their care for irrigation.

If you come to us for your irrigation training, there are a variety of irrigation systems available and the physiologist that you will see will discuss the options with you. We can provide you with a trial system depending on which system you decide to go for. The physiologist will show you how to use the equipment and explain what support you will have once you start to use the irrigation system. We will contact your GP again to let them know which irrigation system you have chosen, as it is your GP that will pay for the irrigation system, the only thing that you will pay for is the usual prescription charge. The irrigation system is delivered to your home, and you will let the company know when you need your next prescription.

When you come for your appointment, it would be helpful to us if you could bring a list of your medications with you.

If you have any heart or breathing problems/conditions, we would appreciate it if you could notify us of these conditions before you attend for your appointment.

What is Rectal Irrigation?

Rectal irrigation is a manual irrigation of your bowel using water and either a cone or tube system. You will do the irrigation yourself at home. You will be required to insert a special cone or tube into your back passage and irrigate your bowel with warm water. Do not worry, we will show you how to use the system you decide to use.

How long will it take?

We usually allow an hour for the first session to discuss the irrigation with you and to assess your suitability for the treatment. We don’t irrigate on that first session as there is a lot of information to take in, and we have found through experience that patients prefer to do their first irrigation in their own home. If, however, you are having some difficulty you can bring your own irrigation system into the department, and we can do an irrigation with you to sort out any issues you may have. When you come to do the irrigation, yourself it will take around 30 minutes, some people find it doesn’t take as long as this and others a little longer. Rectal irrigation is safe to use long term, and we suggest you use it for a minimum of 8-12 weeks, as this is the average amount of time before people start to see an improvement with their symptoms.

For those patients with constipation the average irrigation is every other day. However generally most people use the irrigation as and when they feel they need to, which may be every other day or one to two times per week, and in some cases daily.

Will I need special medication, and will I be able to take my usual medication?

We do not ask you to take any medication prior to the sessions. We do not require bowel preparation.

You can continue with your usual medication; you do not need to stop any medication.

Is the irrigation painful?

Irrigation should not cause you any pain, but it will feel unusual. Very rarely people find it uncomfortable. If you do get pain and it is severe STOP irrigating and seek medical attention immediately.

Will I be able to ask questions?

You can ask questions at any time prior to, during and after the session.

What happens when the rectal irrigation training is finished?

We will follow you up by telephone for up to a year. After that we will refer you back to your referring consultant for follow up. You can contact us at any time should you have any questions or problems.

Benefits and Risks

The benefit of having this treatment is that it may help to improve your symptoms. Depending on the outcome of the treatment it will help your doctor to decide on your future management.

There is a small risk of bowel perforation (a tear) associated with rectal irrigation. This is very rare (1:500,000). Some people find the positioning of the tube or cone uncomfortable, but this is quite normal.

There is no similar alternative to this therapy other than not going ahead with this treatment.

If you have any questions please contact the Department, the contact details are on your appointment letter.

Smoking Policy

Northern Care Alliance operates a smoke free policy. To find out what this means for you, pick up the leaflets available at the hospital. For advice on stopping smoking contact 0161 212 4050.