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Peristeen transanal irrigation system for managing bowel dysfunction

This is a new guideline from NICE on the use of the Peristeen transanal irrigation system for managing bowel dysfunction.

Peristeen is otherwise known as Coloplast; patients use it every other day. It reduces faecal incontinence and can relieve and prevent constipation. Patients sit on a toilet or commode or shower chair. The system includes a rectal catheter with inflatable balloon, a manual control unit with a pump and a bag to hold water. If anyone's mind is boggling, there's a useful video and information on the manufacturer's website.

It can help patients with bowel dysfunction caused by a range of conditions, eg neurogenic (spinal cord injury, MS, Parkinson's etc) or non-neurogenic. NICE advises that Peristeen by used after trials of medication, dietary changes and physiotherapy. They do advise that it can take several weeks for patients to get used to the system and that some will stop using it.

There are other such systems available. Patients need proper training in how to use the system, so I guess we won't be starting it, but will likely get involved with prescribing the catheters and bags.

I’m a freelance GP locum in Winchester & Southampton.

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