In this article, we are going to cover what is bowel irrigation or TAI and digital evacuation. People with Spina bifida have bowel dysfunction, which causes this issue. The procedures below often manage conditions like chronic constipation, fecal incontinence, and neurogenic bowel.
What is Bowel Irrigation Or TAI?
For most people, emptying the bowel is straightforward. However, it doesn’t work smoothly for people with Spina bifida. If you experience constipation, bowel leakage, or spend too much time on the toilet, bowel irrigation might be one of the suitable treatment options. This procedure varies from person to person and country to country depending upon, what type of tools are available. Typically, the procedure involves inserting a rectal catheter and flushing the bowel with lukewarm water. Insert a rectal catheter with a balloon or a cone catheter (without a balloon) into the rectum. Inflate the balloon to hold the catheter in place while instilling the water. After instilling the water, remove the catheter, and empty the bowel.The water softens the stool and stimulates peristatic movements, which help the stool move towards the rectum for evacuation.
If a person has had the MACE procedure, they can administer enemas or irrigation at the beginning of the colon instead of through the rectum at the end. The Malone Antegrade Continence Enema (MACE) procedure, also known as an appendicostomy, is a surgical procedure that creates a passageway from the abdomen to the colon. We will talk about MACE procedure in detail in a different article. MACE has some downsides which most healthservice providers don’t mention.
Bowel irrigation, also known as rectal irrigation or trans-anal irrigation (TAI), empties the lower bowel. It is a treatment option when other methods like medications, dietary changes, and fluid adjustments, have not been effective.
How Does Bowel Irrigation Work?
Insert a rectal catheter with a balloon or a cone catheter (without a balloon) into the rectum. Inflate the balloon in the rectum to hold the catheter in place while instilling the water. This initiates the bowel movements, that moves the stool toward the rectum. After instilling the water and removing the catheter, the bowel can be emptied. Perform the procedure on the toilet, and you can do your bowel irrigation at home.
Regularly performing this procedure will effectively empty your bowel, keeping it clear until the next irrigation. This allows you to choose the time and place for bowel emptying, giving you greater control and convenience.
What is Digital Evacuation?
Another effective method for individuals with severe constipation and neurogenic bowel is digital evacuation. Also known as digital disimpaction, this procedure involves using a finger, with or without gloves and lubrication, to manually remove stool from the rectum. This method is very helpful, especially for severe constipation, and can be used with or without bowel irrigation. It’s important to learn this procedure from a healthcare professional or someone experienced in it. Most people we know prefer using the middle finger for digital evacuation. The best part about this procedure is that you don’t need any tools—just some water or lubricant. You can do it anywhere, in any setting. We will discuss this in detail in another article.
Some advantages of digital evacuation compared to bowel irrigation are:
- Quick Relief: Provides immediate relief from severe constipation and rectal discomfort.
- No Equipment Needed: Requires only a gloved, lubricated finger, making it simple and accessible.
- Effective for Impaction: Particularly useful for removing hard, impacted stool that other methods can’t address.
- Minimal Preparation: Does not require extensive preparation or setup.
- Immediate Results: Offers quick results, often within minutes.
- Useful in Emergencies: Can be performed in urgent situations where other methods might not be feasible
What are the Benefits of Bowel Irrigation and Digital Evacuation?
Here are some benefits of a regular bowel irrigation routine:
- Prevents Constipation: Helps maintain regular bowel movements and prevents constipation.
- Reduces Bowel Leakage: Minimizes the risk of accidental bowel leakage.
- Improves Comfort: Reduces discomfort and bloating associated with irregular bowel movements.
- Enhances Quality of Life: Provides greater control over bowel management, improving overall quality of life.
- Saves Time: Reduces the time spent on the toilet, making daily routines more efficient.
- Promotes Independence: Allows individuals to manage their bowel health independently.
- Reduces Medication Dependence: Decreases the need for laxatives and other bowel-related medications.
- Supports Social Activities: Enables participation in social activities without the worry of bowel issues.
Please Note
The information provided on our website is not intended as medical advice for any individual. Since specific cases may differ from the general information presented, SASHA recommends consulting a qualified medical or other professional for personalized advice.
About the author
Raul/DJ Vivek
Meet Vivek Bharadwaj, a remarkable individual who has defied the odds and soared to new heights despite living with Spina bifida. As the founder of the Sasha Foundation, Vivek tirelessly advocates for others facing similar challenges. His unwavering commitment to support, awareness, and empowerment had made a lasting impact on the Spina bifida community.
