For many people with Spina Bifida, bowel management is a part of everyday life. A bowel program can help manage constipation and bowel accidents, but successful bowel management means more than simply having a routine.
What does successful bowel management look like?
A successful bowel management plan should help support independence, confidence, and participation in daily activities. If bowel care takes too much time, accidents continue to occur, or your routine limits the activities that matter to you, it may be time to reassess your treatment options.
When a bowel management plan is working well, it may help provide:
- Fewer bowel accidents
- Less constipation
- More predictable bowel emptying
- Less time spent on bowel care
- Greater independence
- Improved quality of life
What is the bowel care treatment pyramid?
Bowel management is often approached using a stepwise treatment plan, sometimes called a treatment pyramid. For individuals with Spina Bifida, treatment guidelines typically start with less invasive options and progress to additional therapies, like transanal irrigation, when needed 1.
Conservative bowel management strategies form the foundation of the pyramid. These are the approaches most people try first to help manage constipation and bowel accidents. Many individuals use a combination of conservative strategies as part of their bowel management program.
Conservative bowel management strategies may include:
- Diet and fluid changes
- Oral medications
- Scheduled toileting
- Suppositories or mini-enemas
- Manual bowel emptying techniques (digital stimulation)
What happens when standard treatments are not enough?
Some people continue to experience bowel accidents or constipation despite following their bowel program. Others may spend an hour or more on bowel care each day. Over time, it can be easy to accept these challenges as “just the way things are.”
However, ongoing constipation, bowel accidents, or lengthy bowel care routines may be signs that the current bowel management plan is not successful. Recognizing these challenges and discussing them with a healthcare provider is an important first step.
If you are experiencing bowel issues or are unsure how to talk to your healthcare provider about your bowel routine, you can use the Bowel Check tool to initiate a conversation.
Transanal irrigation is a second-line treatment for bowel management
Transanal irrigation (TAI) is a second-line treatment option for people with neurogenic bowel dysfunction whose bowel management goals are not being achieved with conservative strategies alone.
TAI uses water to help empty the lower bowel at a planned time. Water is introduced into the bowel via the rectum using a balloon catheter which creates a seal in the rectum to keep the water in the bowel during irrigation. Water and stool are then evacuated into the toilet. Research has shown that TAI can be an effective and consistent bowel emptying technique and can help users remain continent for up to 2 days between bowel care sessions.2
By helping to empty the bowel more completely, TAI may improve predictability between bowel care sessions and provide greater confidence in day-to-day activities.3
For individuals whose bowel management goals are not being met with standard treatments alone, TAI may be an option to discuss with a healthcare provider before considering more invasive or surgical interventions. You can ask your provider about transanal irrigation with Peristeen® Plus.
The bottom line
Successful bowel management is about more than avoiding accidents. It is about having a bowel care plan that supports independence, confidence, and participation in everyday life.
Working together, patients, caregivers, and healthcare providers can identify solutions that help achieve meaningful bowel management goals and improve quality of life.
For more support on managing your bowel routine, visit Coloplast Care or contact a Care Advisor.
This blog post was sponsored by Coloplast Corp.
Disclaimer: Coloplast Corp. provides this information solely for educational purposes. This information should not replace professional medical advice and should not be interpreted as treatment recommendations. Always seek advice from your healthcare provider for any medical conditions or judgments regarding medical care
Information from Coloplast Care is for educational purposes only. It is not intended to substitute for professional medical advice and should not be interpreted to contain treatment recommendations.
Beierwaltes, P, et al. (2023). Bowel Function and Care. Guidelines for the Care of People with Spina Bifida. Spina Bifida Association.
Emmanuel et al. Consensus review of best practice of transanal irrigation in adults. Sponsored by Coloplast. Spinal Cord. 2013; (51): 732-738.
Christensen et al. A Randomized, Controlled Trial of Transanal Irrigation. 2006.
