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Review

Transanal Irrigation for Neurogenic Bowel Disease, Low Anterior Resection Syndrome, Faecal Incontinence and Chronic Constipation: A Systematic Review

1
Department of Surgery, Aarhus University Hospital, DK8200 Aarhus, Denmark
2
Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, DK8200 Aarhus, Denmark
3
Department of Clinical Medicine, Aarhus University, DK8200 Aarhus, Denmark
4
GI Physiology Unit, University College London Hospital, London NW1 2BU, UK
5
Department of Hepatology and Gastroenterology, Aarhus University Hospital, DK8200 Aarhus, Denmark
*
Author to whom correspondence should be addressed.
Academic Editor: Bruno Annibale
J. Clin. Med. 2021, 10(4), 753; https://doi.org/10.3390/jcm10040753
Received: 30 December 2020 / Revised: 6 February 2021 / Accepted: 8 February 2021 / Published: 13 February 2021
(This article belongs to the Special Issue Neurogenic Bowel Dysfunction)
Transanal irrigation (TAI) has received increasing attention as a treatment option in patients with bowel dysfunction. This systematic review was conducted according to the PRISMA guidelines and evaluates the effect of TAI in neurogenic bowel dysfunction (NBD), low anterior resection syndrome (LARS), faecal incontinence (FI) and chronic constipation (CC). The primary outcome was the effect of TAI on bowel function. Secondary outcomes included details on TAI, quality of life (QoL), the discontinuation rate, adverse events, predictive factors for a successful outcome, and health economics. A systematic search for articles reporting original data on the effect of TAI on bowel function was performed, and 27 eligible studies including 1435 individuals were included. Three randomised controlled trials, one non-randomised trial, and 23 observational studies were included; 70% of the studies were assessed to be of excellent or good methodological quality. Results showed an improvement in bowel function among patients with NBD, LARS, FI, and CC with some studies showing improvement in QoL. However, discontinuation rates were high. Side effects were common, but equally prevalent among comparative treatments. No consistent predictive factors for a successful outcome were identified. Results from this review show that TAI improves bowel function and potentially QoL; however, evidence remains limited. View Full-Text
Keywords: transanal irrigation; neurogenic bowel dysfunction; low anterior resection syndrome; faecal incontinence; chronic constipation; bowel dysfunction; quality of life transanal irrigation; neurogenic bowel dysfunction; low anterior resection syndrome; faecal incontinence; chronic constipation; bowel dysfunction; quality of life
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MDPI and ACS Style

Mekhael, M.; Kristensen, H.Ø.; Larsen, H.M.; Juul, T.; Emmanuel, A.; Krogh, K.; Christensen, P. Transanal Irrigation for Neurogenic Bowel Disease, Low Anterior Resection Syndrome, Faecal Incontinence and Chronic Constipation: A Systematic Review. J. Clin. Med. 2021, 10, 753. https://doi.org/10.3390/jcm10040753

AMA Style

Mekhael M, Kristensen HØ, Larsen HM, Juul T, Emmanuel A, Krogh K, Christensen P. Transanal Irrigation for Neurogenic Bowel Disease, Low Anterior Resection Syndrome, Faecal Incontinence and Chronic Constipation: A Systematic Review. Journal of Clinical Medicine. 2021; 10(4):753. https://doi.org/10.3390/jcm10040753

Chicago/Turabian Style

Mekhael, Mira, Helle Ø. Kristensen, Helene M. Larsen, Therese Juul, Anton Emmanuel, Klaus Krogh, and Peter Christensen. 2021. "Transanal Irrigation for Neurogenic Bowel Disease, Low Anterior Resection Syndrome, Faecal Incontinence and Chronic Constipation: A Systematic Review" Journal of Clinical Medicine 10, no. 4: 753. https://doi.org/10.3390/jcm10040753

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