Effective Treatments Are Available
By Dianne Skube
As children might say, “Everyone poops.” Although people may not talk about bowel issues, they are important to health, well-being and quality of life. In fact, studies have shown that bowel function is a source of distress for more than half of people with spinal cord injuries (SCI).
People with SCI are often taught to combine different techniques for their bowel programs—especially the use of digital stimulation, medications and/or suppositories. The most common problems people report are constipation, incontinence, hemorrhoids, bleeding and pain.
SCI changes how the intestines work. Special X-rays show that SCI causes food to take longer to travel through the colon. The longer it takes to go through the digestive tract, the more fluid gets absorbed there. This makes the stool drier, which can increase constipation and the ability to empty satisfactorily.
“Incontinence” is defined as “unplanned bowel movements or bowel accidents.” Constipation and incontinence can occur at the same time, when fluid leaks around stool that is stuck or moving too slowly. And, sometimes, trying to relieve constipation with things such as diet changes, laxatives, etc., can lead to more accidents or leaking.
Dealing with bowel accidents—or even just having to worry about the possibility of accidents—can affect confidence, limit social activities and interfere with everyday life. Regular and pain-free defecation, at a chosen time and place, is a key aspect of physical and emotional wellbeing. Loss of conscious control of bowel movements, pain, bloating and discomfort can be socially disabling and put a serious strain on quality of life. In addition, many people with SCI find that they have to spend a significant part of their day on bowel-management procedures. Fecal incontinence (FI) can be extremely upsetting, but effective treatments are available.
Coloplast has recently introduced a new bowel-management system called Peristeen anal irrigation (PAI). PAI is a unique way of emptying the bowel and is used to prevent FI, constipation, and reduce the amount of time spent on bowel management. It is designed to put patients back in control of their bowel function, giving them the confidence and independence to get on with other activities. This, in turn, benefits emotional, social and physical well-being.
Irrigation of the bowel with PAI empties feces in a controlled manner. In patients with FI, the colon and rectum are emptied so efficiently that new feces will not reach the rectum before the next irrigation—on average, two days later—thereby preventing accidents.
In people with SCI who have chronic constipation, regular emptying of the recto-sigmoid area promotes mass movement and transport of stools through the entire colon, helping to prevent blockages. PAI takes less time than many conservative bowel-management procedures, so people can reduce the time that they need to spend on bowel care. PAI is also associated with significantly fewer urinary tract infections than conservative bowel-management procedures.
How Does PAI Work?
PAI assists the evacuation of feces from the bowel by introducing water into the rectum and colon via the anus. The water is subsequently emptied into the toilet, together with the contents of the descending colon, sigmoid colon and rectum. Whether people experience FI, chronic constipation or both, PAI can help re-establish controlled and regular bowel function.
Who Can Benefit From PAI?
PAI can be used to manage FI and chronic constipation in anyone over three years of age. These symptoms are often associated with bowel dysfunction due to neurological damage (neurogenic bowel). Causes of neurological damage include SCI, spina bifida and multiple sclerosis. Functional bowel disorders, such as obstetric trauma to the anal sphincters and slow transit, can also be helped. The PAI system is designed to be easy to handle so that a wide range of people—including those with impaired manual dexterity—can use it to regain independence.