Prospective study of colonic irrigation for the treatment of defaecation disorders

• Published in: British journal of surgery Vol. 95; no. 10; pp. 1273 - 1279
• Main Authors: Koch, S. M. P., Melenhorst, J., van Gemert, W. G., Baeten, C. G. M. I.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-10-2008; Wiley
• Subjects: Biological and medical sciences; Colon; Constipation - physiopathology; Constipation - therapy; Defecation - physiology; Fecal Incontinence - physiopathology; Fecal Incontinence - therapy; Female; General aspects; Humans; Male; Medical sciences; Middle Aged; Prospective Studies; Quality of Life; Therapeutic Irrigation - methods; Medicine; Prospective; Irrigation; Treatment; Colon; Surgery
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.6232

Background:
Retrograde colonic irrigation is a possible treatment for defaecation disorders when conservative treatment or surgery has failed. The aim of this prospective study was to investigate its effectiveness.
Methods:
Patients were divided into three groups: those with faecal incontinence (A), constipation (B) or both (C). The Biotrol® Irrimatic pump or the irrigation bag was used for colonic irrigation. Patients completed a questionnaire at baseline and after 3, 6 and 12 months, as well as a Short Form 36 health survey and an American Society of Colon and Rectal Surgery quality of life questionnaire at baseline and after 6 months.
Results:
The study included 39 patients (26 women; mean age 58·0 years). In group A, 11 of 18 patients were pseudocontinent for faeces at 3 months (P < 0·001). Parks' incontinence scores decreased for all patients in this group at 3 months (P < 0·001), 6 months (P = 0·036) and 1 year (P = 0·005). In group B, three of ten patients reported a major improvement. The mean score for the feeling of incomplete evacuation decreased at 3 months (P = 0·007), 6 months (P = 0·013) and 1 year (P = 0·036). In group C, six of ten patients became pseudocontinent for faeces (P = 0·009) and three reported improvement in constipation . The overall quality of life scores improved (P = 0·012).
Conclusion:
Retrograde colonic irrigation is an undervalued but effective alternative treatment for intractable defaecation disorders. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Should be considered before performing surgery