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Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis

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Anorectal function after long-term transanal colonic irrigation.

P M Faaborg¹, P Christensen, S Buntzen

¹Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland

|January 15, 2010

Summary

Long-term transanal colonic irrigation (TAI) use increased rectal volumes in constipation patients but decreased anal pressures in fecal incontinence patients. These changes are likely due to adaptation and the natural course of fecal incontinence, not TAI-induced rectal wall or sphincter damage.

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Area of Science:

Gastroenterology
Colorectal Surgery
Physiology

Background:

Transanal colonic irrigation (TAI) is increasingly utilized for managing chronic constipation and fecal incontinence.
Understanding the long-term effects of TAI on anorectal function is crucial for patient management.

Purpose of the Study:

To investigate the long-term impact of TAI on anorectal physiological parameters in patients with chronic idiopathic constipation (CC) and idiopathic fecal incontinence (FI).

Main Methods:

Anorectal manometry and rectal balloon distension tests were conducted on 12 CC and 10 FI patients.
Physiological assessments were performed before and after a median of 68 months of TAI use.

Main Results:

In CC patients, TAI significantly increased median urge rectal volume (121 to 268 ml).
In FI patients, TAI increased median urge volume (125 to 158 ml) and maximum tolerable volume (156 to 253 ml), but decreased median anal resting pressure (48 to 32 cmH2O) and squeeze pressure (69 to 38 cmH2O).
Rectal compliance, volume at first sensation, and anal sensory level remained unchanged in both groups.

Conclusions:

Increased rectal volumes in CC patients likely reflect patient adaptation to TAI rather than altered rectal wall properties.
Deterioration of anal sphincter function in FI patients is more likely attributable to the natural progression of the condition than to long-term TAI.
Long-term TAI appears safe concerning rectal compliance and anal sensation, with observed functional changes potentially linked to patient adaptation and disease progression.