Introduction to Peristeen Anal Irrigation for Healthcare Professionals

Get an animated insight into how the digestive system works and learn more about bowel irrigation as a technique to help your patients empty their bowels. Watch the effect that transanal irrigation has on the bowels visualized by means of scinitigraphic imaging of the colon.

The benefits of using Peristeen:

  • Prevents fecal incontinence and constipation, for up to two days between irrigations
  • Enables the patient to decide when to empty their bowels, so it fits in with their lifestyle
  • Improves quality of life
  • Reduces the total time spent daily by the patient on their bowel management
Learn more about bowel irrigation

What is transanal irrigation?

This animation will show you the principle mechanism of transanal irrigation (TAI) with Peristeen. You can use it to help you discuss with your patients whom you have deemed suitable to initiate TAI. The animations will help you explain in visual and easy to understand way how the product works.

Learn more about bowel irrigation
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What is transanal irrigation?

How does transanal irrigation work?

Peristeen empties the bowel by introducing water through the anus and rectum using a rectal catheter. It is performed whilst sitting on the toilet. The water is then emptied from the bowel, along with the stool, into the toilet. The lower part of the bowel is emptied efficiently, enabling most users to irrigate only every other day.
Used routinely, daily or every other day, Peristeen can reduce bowel leakage and constipation, making it easier to take part in social activities, go to work or travel.

The benefits of using Peristeen:

  • Prevents fecal incontinence and constipation, for up to two days between irrigations
  • Enables the patient to decide when to empty their bowels, so it fits in with their lifestyle
  • Improves quality of life
  • Reduces the total time spent daily by the patient on their bowel management

And that’s not all…

By reducing the risk of bowel accidents, Peristeen can also help prevent urinary tract infections (UTI's) and it may increase independence in some patients currently needing help to empty their bowels.

Watch the animation video to learn more about Peristeen and how it can help your patients suffering from bowel dysfunction.

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Animated User Guides

The below animated user guides (one for adult patients and one for children) will help you instruct your patients on how to use Peristeen Anal Irrigation system. Patient education and training is crucial to ensure the correct and effective use of the product.

 Vidoe on Step-by-step bowel irrigation guide

Adult patients: Getting started with bowel irrigation

An animated guide to show your adult patients how to irrigate their bowels using Peristeen Anal Irrigation system.

Watch the step-by-step bowel irrigation guide
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Adult patients: Getting started with bowel irrigation

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Take your time

Using Peristeen will mean your patients need to get used to a new routine, but the effort will many times pay off. Regular and predictable emptying of their bowels can make a big difference to a patient’s quality of life, as well as improve symptoms of constipation and faecal incontinence.

Three important things to remember when teaching a patient how to get started: 

 

Use Peristeen regularly

Follow the instructions and keep to the plan that you (the patient’s doctor or nurse) have recommended. Regular bowel emptying with Peristeen helps prevent leakage and constipation. It can also reduce the time your patient needs to spend taking care of their bowels.

 

Help your patients identify a time to empty their bowel without being rushed

The exact time is not critical, but try to keep to the same each day, so that they get in a regular routine. In order to align expectations, let your patient know that it may take 2 to 4 weeks (and in rare occasions more) until they achieve a stable routine and master the technique.

 

Train your patient

Make sure the patients understand how to use the product and that they are properly trained. Encourage them to keep in regular contact with their doctor or nurse during the first few months of using Peristeen. You can help with any queries they might have and help them adjust their routine if needed. They can also enroll or contact Coloplast Care for advice and support.

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teach children to empty their bowel

Paediatric patients: Helping children empty their bowels

Learning how to empty their bowels is an important step in every child’s development. It helps them feel more confident and gives them the freedom to take part in social activities like swimming or playing with friends.

Watch step-by-step bowel guide for children
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Paediatric patients: Helping children empty their bowels

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Many children with bowel dysfunction, especially when they are younger and those affected by conditions such as spina bifida, rely on their parents to help them empty their bowels. Traditional methods to prevent bowel leakage and constipation include change of diet, suppositories, enemas, constipating pharmacological agents, stool softeners and laxatives

More predictable

Some children, however, find these methods of treating the bowels ineffective, as you cannot schedule when you will have a bowel movement, which often results in bowel accidents.
Transanal Irrigation (TAI) is one type of bowel care routine that ensures bowel movements are both regular and predictable. If performed regularly, it will make the child feel more comfortable and prevent problems such as faecal incontinence and constipation.

Using Peristeen in children

To see the clinical evidence of Peristeen in the paediatric patient population, check the section Clinical Evidence, where you will find a downloadable summary containing data from 11 studies.

Training of the child and its parents or caregivers is key to ensure a correct and effective use of the product.

Help the child, its parents and/or caregivers to find a good, regular routine that works for them, and encourage the child to take an interest. They will have to do it themselves when they are older, and some studies in children with anorectal malformations using Peristeen have shown that self-management increases patients adherence to the treatment and may help to shorten the total time it takes to irrigate (Märzheuser et al. Eur J Pediatr Surg. 2016 Apr;26(2):186-91).

It can be a good idea to keep track of the child’s progress. For inspiration, why not download and print a the Bowel Emptying Diary (pdf, 1MB).

 



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The NBD Score

Bowel function tool Bowel management can be a difficult subject to talk about with your patients suffering from neurogenic bowel dysfunction (NBD). Furthermore, it can be difficult to measure the severity of NBD and subsequent improvements after initiating or altering a bowel management strategy. The NBD score (1) can be a valuable tool for you. Download it here for free
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What is the NBD Score?

References

(1): Krogh K, Christensen P, Sabroe S, Laurberg S. Neurogenic bowel dysfunction score. Spinal Cord 2006;44:625–631

(2): Passananti V. et al. Long-term efficacy and safety of transanal irrigation in

multiple sclerosis. Neurogastroenterology & Motility (2016). doi: 10.1111/nmo.12833

It’s a validated, symptoms-based questionnaire developed to measure the level of neurogenic bowel dysfunction in spinal cord-injured (SCI) patients. It was originally validated in the Danish SCI patient population, and has since then been translated and validated in other languages.

The combination of responses creates four levels of dysfunction: 0-6 very minor, 7-9 minor, 10-13 moderate and 14-47 severe.

The NBD score is simple to use, consisting of only 10 questions, and can be filled out by the patient. Even though initially validated in the SCI population, there are reports in the literature of its use in other neurogenic patient groups, such as Multiple Sclerosis (MS). (Ref 2).

We hope the NBD score will be a helpful tool in your daily practice and help you to better diagnose and follow-up of your patients with neurogenic bowel dysfunction.

Download or print the NBD score

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Pediatric Tools

Teach your child bowel irrigation

Teaching children to empty their bowels using the Poo Game

Teaching children to use Peristeen with The Poo Game A fun way to help children (and their parents) learn to use Peristeen. The Poo Game is a card-based game that teaches them the basic steps, and encourages children to use the product independently. The Poo Game

The Poo Game

The Poo Game is a set of cards that can be used by you or the parents of your patients to teach children how to empty their bowels using Peristeen. The cards can be used to play different fun games that can be adapted to suit age and skills. Simply print the cards, cut them out and you’re ready to play.

The Poo Game has been designed to help parents/carers and children learn toilet habits in a fun way. It’s simple to use and as the child gets the hang of it, it’s easy to make it more challenging. Have fun!

Download playing cards (pdf, 1MB)

Download instructions (pdf, 1MB)

icon  Remember: The Poo Game is meant as a training supplement, not to replace actual instructions for use. Formal training of the child patient and its parents/caregivers is essential to ensure a correct, effective and safe use of the product.

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NHS Patient Safety Alert on Bowel Care Pathways

NHS Improvement has issued a Patient Safety Alert requiring all NHS healthcare providers treating patients with neurogenic bowel dysfunction to ensure that policies, procedures and appropriately trained staff are in place to meet patient needs by 25th January 2019.

Read more on how Coloplast can support healthcare providers in adhering to the Alert (pdf)

Regulated by the Care Quality Commission (CQC)

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