Transanal irrigation in the management of neurogenic bowel dysfunction

Many patients with a spinal cord injury (SCI) or spina bifida suffer from neurogenic bowel dysfunction which causes significant physical and psychological morbidity. For the last four years at the National Rehabilitation Hospital, transanal irrigation (TAI) has been offered to patients who were dissatisfied with a conservative bowel management programme. This is an observational study of eleven patients who were offered TAI. Three questionnaires, scoring bowel symptoms at baseline and follow-up (3-28 months) were completed by patients. Nine patients had a SCl and two had spina bifida, mean age was 44 years. A reduction in mean scores for all three questionnaires occurred post TAI (39.5-42.1%) indicating fewer bowel symptoms. Statistically significant reductions in faecal incontinence (p < 0.05), abdominal pain (p < 0.05) and lifestyle alterations secondary to bowel management (p < 0.05) occurred. No serious adverse events occurred during the study. TAI is an effective treatment option for the management of neurogenic bowel dysfunction.