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

Defecation function is negatively impacted in patients with neurogenic bowel dysfunction (NBD), who require effective bowel care for stool evacuation. NBD comprises fecal incontinence and/or constipation, which can reduce the quality of life and dignity. Transanal irrigation (TAI) is recommended by...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-03, Vol.13 (6), p.1527
Main Authors: Rodriguez, Gianna, Kirshblum, Steven, Thao, Mai, McArthur, Mackenzie, Camilleri, Michael
Format: Article
Language:English
Subjects:
Care and treatment
Clinical medicine
Clinical practice guidelines
Clinical trials
Colon
Consortia
Constipation
Defecation
Development and progression
Fatty acids
Fecal incontinence
Feces
Irrigation (Medicine)
Laxatives
Medical equipment and supplies industry
Medical research
Medical test kit industry
Medicine, Experimental
Methods
Microbiota
Motility
Nervous system
Neurophysiology
Pacemakers
Pathophysiology
Pelvis
Physiology
Practice guidelines (Medicine)
Review
Spina bifida
Spinal cord injuries
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Summary:Defecation function is negatively impacted in patients with neurogenic bowel dysfunction (NBD), who require effective bowel care for stool evacuation. NBD comprises fecal incontinence and/or constipation, which can reduce the quality of life and dignity. Transanal irrigation (TAI) is recommended by several clinical guidelines as the second-line treatment after conservative treatment and before surgical options are considered. As the only class in the second-line treatment with an established safety and efficacy profile, the mechanism of action of TAI has not fully been elucidated when administered through a rectal catheter with a balloon. This review examines the current understanding regarding the mechanism of action of TAI, with a focus on the pathophysiology of neurogenic bowel and irregular defecation. By understanding the functional implications of TAI, clinicians may be better able to integrate this modality into bowel care programs, especially for patients with NBD who have significant constipation due to delayed colonic motility and impaired stool emptying with loss of voluntary control of defecation, and those who are unresponsive to conservative treatment, including enemas.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13061527