3 Current practice

3 Current practice

Bowel dysfunction may be caused by a neurogenic disorder (such as spinal cord injury, spina bifida, multiple sclerosis or Parkinson's disease) or by a non-neurogenic disorder (such as injury to the rectum or bowel, slow-transit constipation or obstructed defaecation symptoms). Current treatment options include medication, changes to diet, physiotherapy and surgery. People may also be offered training to help manage their symptoms at home, using biofeedback, bowel washouts and manual removal of faeces. The NICE guideline on managing faecal incontinence in adults states that a combination of management strategies is likely to be needed. People with faecal incontinence should be offered advice on a range of coping strategies and treatment options and are encouraged to find the methods that work best for them. There is currently no NICE guidance on managing bowel dysfunction in children.

If bowel management cannot be achieved by conservative management, strategies such as transanal irrigation should be considered. A number of different transanal irrigation systems are available, including Peristeen. Clinicians and people with bowel dysfunction should discuss the options available and may try a number of devices before deciding on a preferred system. Some people may need surgery, most often a colostomy, ileostomy or a procedure to allow treatment with anterograde continence enemas (ACE procedure).


This page was last updated: 28 January 2019