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). 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