Prospective study of colonic irrigation for the treatment of defaecation disorders.
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).


CONCLUSIONS
Retrograde colonic irrigation is an undervalued but effective alternative treatment for intractable defaecation disorders.
Koch
S M P
SM
Department of Colorectal Surgery, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
Melenhorst
J
J
van Gemert
W G
WG
Baeten
C G M I
CG
D003106:Colon; D003248:Constipation / Q000503:physiopathology / Q000628:therapy*; D003672:Defecation / Q000502:physiology; D005242:Fecal Incontinence / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D007507:Therapeutic Irrigation / Q000379:methods