Sistema de Salut de Catalunya
Institut Català de la Salut
[Vollebregt PF] Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands. Blizard Institute, Queen Mary University London, London, UK. [Baeten CIM] Department of Surgery, Groene Hart Hospital, Gouda, the Netherlands. [Drewes AM] Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark. [Marinello F] Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain. [Martelluci J] Emergency Sugery/Pelvic Floor Center, Careggi University Hospital, Florence, Italy. Collegium Medicum, SAN University, Lodz, Poland. [Mekhael M] Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
Vall d'Hebron Barcelona Hospital Campus
2026-03-04T07:24:03Z
2026-03-04T07:24:03Z
2025-11
Constipation; Faecal incontinence; Irrigation
Estreñimiento; Incontinencia fecal; Irrigación
Restrenyiment; Incontinència fecal; Irrigació
Aim The aims of the study were to: (1) update a systematic review on the efficacy of transanal irrigation (TAI) in patients with chronic constipation (CC) and/or faecal incontinence (FI); (2) provide guidance on the position of TAI in the treatment pathway of CC and FI; and (3) discuss knowledge gaps and areas of future research. Method A collaborative of 11 experts (gastroenterologists, colorectal surgeons, and clinical scientists) from eight European countries was established. The expert group was divided into three main groups, with each group leading a specific section (systematic review, treatment pathway, and knowledge gaps). A previously published systematic review on TAI was updated by conducting an additional search on 12 April 2025. Studies on TAI in specific subgroups (neurogenic bowel dysfunction, low anterior resection syndrome) were excluded. Results Sixteen studies involving 1567 (range 16–507) patients were included. Only one underpowered randomised trial was performed, which demonstrated that high-volume TAI may be more effective than low-volume TAI in patients with CC. Most other studies (observational) showed improvement in symptoms and/or quality of life to some extent, with a large variation in outcomes used. Treatment discontinuation was reported in 3–57% of patients. The position of TAI in the treatment pathway of CC and FI was proposed, and 13 knowledge gaps were provided. Conclusion TAI may be an effective treatment in patients with CC and/or FI. There is a need for randomised controlled trials to study its efficacy and current knowledge gaps.
Paul F. Vollebregt received financial support from Coloplast A/S to write the manuscript.
Article
Published version
English
Irrigació (Medicina); Restrenyiment - Tractament; Incontinència fecal - Tractament; DISEASES::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Signs and Symptoms, Digestive::Constipation; Other subheadings::Other subheadings::/therapy; DISEASES::Digestive System Diseases::Gastrointestinal Diseases::Intestinal Diseases::Rectal Diseases::Fecal Incontinence; Other subheadings::Other subheadings::/therapy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Physical Therapy Modalities::Hydrotherapy::Therapeutic Irrigation; ENFERMEDADES::afecciones patológicas, signos y síntomas::signos y síntomas::signos y síntomas digestivos::estreñimiento; Otros calificadores::Otros calificadores::/terapia; ENFERMEDADES::enfermedades del sistema digestivo::enfermedades gastrointestinales::enfermedades intestinales::enfermedades del recto::incontinencia fecal; Otros calificadores::Otros calificadores::/terapia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::modalidades de fisioterapia::hidroterapia::irrigación terapéutica
Wiley
Colorectal Disease;27(11)
https://doi.org/10.1111/codi.70274
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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