Related Experiment Video
Updated: Feb 4, 2026
Orthotopic Small Bowel Transplantation in Rats
Published on: November 6, 2012
Analysis of direct costs of trans anal saline irrigation to pharmacological measures for bowel dysfunction
Ravi Patcharu1, Santosh Dey2, Karunesh Chand3
1Commanding Officer, 456 Field Hospital, C/o 99 APO, India.
Insights
Transanal irrigation (TAI) is a cost-effective treatment for pediatric bowel dysfunction compared to pharmacological measures (PM). This study found TAI significantly reduced direct costs for children, offering an economical alternative to ongoing PM.
Area of Science:
- Pediatric Gastroenterology
- Health Economics
- Medical Technology Assessment
Background:
- Management of pediatric bowel dysfunction presents significant healthcare costs.
- Pharmacological measures (PM) are common but yield variable outcomes.
- Transanal irrigation (TAI) offers an effective intermediate therapy between failed PM and invasive surgery.
Purpose of the Study:
- To evaluate the direct costs of TAI compared to continued PM in children with bowel dysfunction.
- To assess the economic impact of TAI from a healthcare provider perspective.
Main Methods:
- A cohort of children over 4 years with persistent bowel dysfunction were enrolled.
- Patients were categorized into Constipation, Pseudoincontinence, and Incontinence groups.
- Direct costs of existing PM and TAI were compared over six months, including diaper usage.
Main Results:
- 34 patients (average age 76.7 months) were analyzed.
- TAI demonstrated significant direct cost reductions across all patient groups compared to PM.
- A notable decrease in daily diaper usage was observed with TAI.
Conclusions:
- Transanal irrigation (TAI) is an effective and economically advantageous treatment for pediatric bowel dysfunction.
- TAI should be considered as an early management option to reduce healthcare expenditures.
- This cost analysis supports TAI as a financially viable alternative to prolonged pharmacological management.
Background:
Management of bowel dysfunction in children is expensive. Pharmacological measures (PM) are the most commonly used treatment option which has shown to have varying outcomes. The next option after failed PM involves invasive surgical procedures like the Malone Antegrade Continence Enema (MACE). Trans Anal Irrigation (TAI) is an efficacious treatment modality between failed medical therapy and invasive surgeries. As no cost analysis of TAI in children has been conducted, this study evaluated the direct costs involved with TAI in comparison to PM from the health care provider perspective.
Methods:
Children >4 years with persistent bowel dysfunction despite PM, were divided into three groups: Constipation, Pseudoincontinence and Incontinence group. The costs of existing PM and number of diapers used daily were noted for each patient. In all patients, PM was stopped and TAI was initiated. Improvement in symptoms and reduction in daily diaper usage over six months was recorded. The direct costs of TAI versus the costs that would be involved had PM been continued, were compared using paired 't' test.
Results:
34 patients (20 male, 14 female) with an average age of 76.7 months were divided into three groups: Constipation:12, Pseudoincontinence:15 and Incontinence:7. In all groups, there was a significant reduction in direct costs with TAI in comparison to PM.
Conclusion:
In children with bowel dysfunction, TAI is an effective and significantly economical treatment modality in comparison to PM and should be considered early on in the management therapy.
Related Concept Videos
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
00:59Direct-Acting Cholinergic Agonists: Pharmacological Actions
01:27Design Example: Design of an Irrigation Channel
01:26Psychosexual Stages of Personality: Anal
01:23Microbial Growth Measurement: Direct Methods
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...