Introduction

Dealing with bowel problems

Bowel leakage and constipation can have a significant impact on our quality of life. Apart from the frequent physical discomfort and bloating, you may worry about having an accident in public. But help is available. About leakage and constipation
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About leakage and constipation

Common reasons for experiencing bowel issues include:

  • Neurogenic damage caused by spinal cord injury or conditions such as multiple sclerosis or spina bifida
  • Trauma to the rectum e.g. after childbirth
  • Certain medications

Anyone may experience occasional constipation and bowel leakage. If symptoms persist for more than a month, seek medical advice from a healthcare professional.

Possible treatments

If you have chronic symptoms, you may find it useful to follow a set bowel care routine. This may help give you regular bowel movements. Peristeen Anal Irrigation may be a solution to help manage your symptoms.

 

 

 

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Good to know

Common causes of bowel issues

Bowel issues can arise for many reasons and can affect people of all ages. Here we outline some of the most typical causes and symptoms Causes of bowel problems
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Typical causes of bowel problems

The most common bowel issues people experience are:

  • Bowel leakage – when you cannot control when your bowels open, resulting in bowel accidents
  • Constipation – when stool in the bowel stays there for too long and becomes too hard to pass, resulting in the inability to have a bowel movement
  • A combination of the two-You can be constipated but still experience loose stool that leaks past the hard stool

Some of the signs of bowel leakage include:

  • Feeling the urge to have bowel movement but not being able to control when your bowels open, resulting in a bowel accident (urge incontinence)
  • Leaking stools (passive incontinence)
  • Soiling of underwear
  • Being unable to control when you pass air (flatus)

Some of the signs of constipation include:

  • Inability to have a bowel movement
  • Bloating
  • Discomfort
  • Severe stomach ache

Causes of bowel issues

It is important to understand that having bowel issues is not a disease in itself. There is usually an underlying cause as to why your bowels aren’t functioning properly.

Some of the common causes of bowel issues are:

  • Neurological disorders such as Spinal Cord Injury, Spina Bifida or Multiple Sclerosis. If you have a neurological disorder, it’s likely the nerves in your spinal cord – which control how the bowel functions – are damaged
  • Complications after rectal surgery, such as after childbirth, where the sphincter muscles have been damaged leading to the inability to control when you go to the toilet
  • Anorectal malformations from birth – even with surgical correction, you can still experience bowel incontinence episodes
  • Reduced tissue elasticity due to old age, leading to frequent soiling

It’s important for anyone who experiences bowel issues to find a bowel routine that allows regular emptying of the bowel, as this helps to prevent both bowel leakage and constipation. Read more about the products Coloplast has to offer. 

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Facts about constipation and bowel leakage

If you have issues with your bowels, you may be able to draw comfort from the fact that you are far from alone. What’s more, there are plenty more ways of overcoming your issues than you might think. More facts on constipation and bowel leakage
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About constipation and bowel leakage

Going to the toilet to have a bowel movement is something most people take for granted. That said, it’s still a very private matter. So when you suddenly experience an issue with your bowels, you can feel rather isolated. It can be embarrassing to speak out about it, which is why many people can go for years without telling anyone about their problem.

 

A common problem

Because many people never visit their doctor or nurse or reveal their symptoms, the exact number of people affected by bowel issues is unknown. But it is more common than you might think:

  • Studies suggest that approximately 2% of the adult population have daily or weekly bowel leakage episodes
  • The prevalence for adults over 65 years is 7%, and in retirement homes it’s as high as 33%
  • Studies indicate that up to 20% of the population have problems with constipation

Finding a solution to your bowel problems

Bowel issues won’t disappear by themselves, so it is important to find a way of dealing with them. There are many ways to look after your bowels. If you’re looking for a way that allows you to decide when to go to the toilet again, then bowel irrigation is a good option.

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Frequently asked question about bowel issues

Here are the answers to some of the most common questions people have about taking care of their bowels. FAQs about bowel issues
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FAQs about bowel issues

How can bowel problems affect my lifestyle?

Bowel leakage and constipation can be very uncomfortable, and they also have a significant impact on our quality of life. Apart from the frequent physical discomfort and bloating, you may worry about having an accident in public.

This makes it important to find a way to manage your bowel issues.

What can I do to manage my bowel problems?

Bowel issues can often be improved by changing diet; there are also several types of medication that can help. Transanal irrigation can be used to help prevent constipation and bowel leakage. Read more about solutions for taking care of your bowels.

What is transanal irrigation?

Transanal irrigation is where water is introduced into the bowel using a rectal catheter. The water stimulates the bowel and flushes out the stool, leaving the lower half of the bowel empty. It’s important to do it regularly to prevent constipation and the risk of bowel accidents.

How often should I irrigate?

For most people, every 1–2 days works well. It’s important to do it regularly to prevent constipation and the risk of bowel accidents. It’s also best to get into a regular routine, rather than changing too much. With time and practice you’ll find out what works best for you. If you’re not sure, ask your doctor or nurse for advice.

What time of the day is best for irrigating?

Try to get into a routine where you irrigate around the same time of the day. Eating and drinking helps the bowel’s natural movement, so about 30 minutes after a meal is a good time. But don’t be afraid to change the routine slightly to suit your day-to-day routine.

Can I travel with the irrigation equipment?

Yes – remember to bring your irrigation system along plenty disposable catheters as they may not sold everywhere. If you’re going to use the system abroad, use bottled or cooled boiled water in places where the tap water is not safe to drink. Remember in different time zones your body may take a while to get used to a new routine. You may also eat different types of food. This can affect the bowels.

Does anal irrigation hurt?

No, transanal irrigation does not normally hurt and is perfectly safe. However it may feel a little strange at first. If it is uncomfortable when the water is pumped in, stop for a while and then continue. If you are in pain, stop irrigating immediately, deflate the balloon and remove the catheter. If the pain persists, contact your nurse or doctor for help.

Are there any risks or complications of irrigating?

Some people experience minor problems such as discomfort or a little bleeding. If the catheter is not inserted correctly, it can cause a hole or tear in the bowel. Follow the instructions you receive from your doctor or nurse.

What should I do if I leak between irrigations?

 Bowel leakage between irrigations may be caused by insufficiently emptying your bowel due to constipation or hard stool. Alternatively, you may be using too much water during irrigation. Contact your doctor or nurse to help you adapt to your bowel plan. 

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How can I deal with my bowel issues?

How can I deal with my bowel issues?

Issues such as bowel leakage and constipation are a common symptoms of conditions that cause damage to the central nervous system.

How to deal with bowel issues
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How can I deal with my bowel issues?

Nerves in the spinal cord control bowel movement and if they are damaged, the feeling of needing to empty the bowel and the movement of stools through the body are affected. As a result, it can be difficult to tell when your bowel is full, and you can also have trouble controlling the release of stools. This can lead to different types of bowel problems: 

  • Bowel leakage
  • Constipation
  • A combination of the two

 

Bowel leakage

Bowel leakage occurs when you are unable to control your bowel muscles. This can result in accidental leakage of stools or having to rush to the toilet. Bowel accidents can be a distressing experience and can also lead to skin irritations and bladder infections, all of which can greatly affect a person’s confidence and general well-being.


Constipation

Constipation occurs when stools in the bowel stay there for too long and become hard and dry. This makes it difficult to pass stools and results in the inability to have a bowel movement. Symptoms vary from person to person but the most common are straining, bloating and severe discomfort.

You may experience a combination of both bowel leakage and constipation – when softer stool or fluid leaks past hard stools stuck in the colon – often culminating in a bowel accident.

Whatever issues you are dealing with, it’s important to find a bowel routine that enables you to continue with your daily life in confidence.

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Manage your bowels with Peristeen®

Manage your bowels with Peristeen®

Peristeen is an innovative anal irrigation system from Coloplast for people who experience fecal incontinence or chronic constipation. Using Peristeen minimizes the likelihood of involuntary bowel leakage.

Learn more about Peristeen®
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Manage your bowels with Peristeen®

How does it work?

Peristeen empties the bowel by introducing water into the bowel using a rectal catheter. It is performed while sitting on the toilet. The water is then emptied from the bowel, along with the stool, into the toilet. The lower part of the bowel is emptied so efficiently that most users only have to irrigate every other day.

Used routinely, Peristeen may help reduce the physical discomfort and mental worry of bowel leakage and constipation, making it easier to take part in social activities, go to work or travel.

The benefits of using Peristeen:

  • Prevents bowel leakage and constipation for up to two days
  • Enables you to decide when to empty your bowels.
  • Lets you choose what time of day you want to irrigate, so it fits in with your lifestyle
  • Improves quality of life

 

And that’s not all…

By minimizing the risk of bowel accidents, Peristeen minimizes the likelihood of skin irritations. It may also help prevent urinary tract infections and help reduce flatulence.

Learn more about Peristeen or contact Consumer Care.

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What is neurogenic bowel?

Bowel dysfunction associated with neurogenic disorders such as spinal cord injuries, spina bifida and multiple sclerosis is commonly known as ‘neurogenic bowel’. Here we outline the most typical symptoms. The neurogenic bowel

Essentially, neurogenic bowel describes a lack of nervous control which prevents the bowel from functioning correctly. It is caused by damage to the central nervous system and may result in bowel leakage, chronic constipation, or both.

Some causes

The most common cause of neurogenic bowel is a Spinal Cord Injury, though it may also result from other neurogenic disorders such as Spina Bifida, Multiple Sclerosis, Parkinson’s disease or diabetes mellitus. The effect on bowel function depends on where the spinal cord is damaged.

There are two types of neurogenic bowel dysfunction – reflex and flaccid bowel.

Reflex bowel

Reflex bowel is where the bowel opens on a reflex basis when the rectum becomes full. The bowel can empty at any given time because the person may have lost the ability to feel when the bowel is full. This can lead to bowel accidents and leakage.

Flaccid bowel

Flaccid bowel is when the anal sphincter muscle – the muscle that normally keeps the anus closed – becomes relaxed and remains open. This often leads to accidental emptying of the bowel.

Neurogenic bowel also leads to a slow stool transit time, meaning people with neurogenic bowel also are at high risk of suffering from constipation.

If you have neurogenic bowel, then it’s important to find a reliable bowel management routine to avoid accidental emptying, constipation and impaction.

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Tips, tools and guides

Getting started using Peristeen®

Getting started using Peristeen®

Using Peristeen® to manage your bowels can be challenging at first, but with the right training and routine, you’ll soon start to see the benefits.

Watch step-by-step Peristeen® guide for adults
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Getting started using Peristeen®

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Using Peristeen® daily or every other day, as recommended by your doctor or nurse, helps prevent bowel leakage and constipation. This means that you don’t have to worry about leakage and can feel confident to do things you want to do.

 

Take your time

Using Peristeen® will mean having to get used to a new routine, but the effort will pay off. Regular emptying of your bowels can make a big difference to your quality of life.

The three most important things to remember when getting started: 

  • Use Peristeen® regularly. Keep to the plan that your doctor or nurse has recommended. Regular bowel emptying with Peristeen® helps prevent leakage and constipation. It can also reduce the time you need to spend taking care of your bowels. 
  • Find a time when you can empty your bowels without being disturbed or rushed. The exact time that you empty your bowel is not critical, but try to keep to the same each day, so that you get in a regular routine. 
  • Keep in regular contact with your doctor or nurse during the first few months of using Peristeen®. They can help you with any queries you might have and help you adjust your routine if needed. You can also contact Coloplast Consumer Care for advice and support.
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Helping children manage their bowels with Peristeen®

Helping children manage their bowels with Peristeen®

Learning how to empty their bowels is an important step in every child’s development. Using Peristeen® can help them feel more confident and give them the freedom to take part in social activities.

Watch the step-by-step guide for children using Peristeen®
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Helping children manage their bowels with Peristeen®

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Most children with spina bifida, especially when they are younger, rely on their parents to help them empty their bowels. Traditional methods to prevent bowel leakage and constipation include change of diet, suppositories, enemas, constipates, stool softeners and laxatives.


More predictable

Some children, however, find these methods of treating the bowels ineffective, as you cannot schedule when you will have a bowel movement, which often results in bowel accidents.

Bowel irrigation is one type of bowel care routine that ensures bowel movements are both regular and predictable. If performed regularly, it will make your child feel more comfortable and prevent problems such as bowel leakage and constipation.


What exactly is bowel irrigation?

Bowel irrigation is when water is introduced into the bowel via the rectum, using a rectal catheter. The water stimulates the bowel and flushes out the stool. The process takes about 30–45 minutes. After irrigating, the lower part of the bowel is empty. Bowel irrigation is performed every 1 to 2 days.

 

It is important to do it regularly as:

  • Regular irrigation prevents bowel accidents, simply because the lower bowel is empty of stool
  • Regular irrigation prevents chronic constipation as it encourages bowel movements, meaning they become regular 

 

Until your child learns how to irrigate himself or herself, you need to make sure that it is done correctly and safely. Find a good, regular routine that works and encourage your child to take an interest. They will have to do it themselves when they are older.

It can be a good idea to keep track of your child’s progress. For inspiration, why not download and print a the Bowel Emptying Diary (pdf, 1MB).

Coloplast offers a bowel irrigation system called Peristeen®.

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Teaching children to empty their bowels using the Poo Game

When a child shows an interest in emptying their bowels, you should start to involve them. A fun way to do this is to use the Poo Game – a card-based game that teaches your child the basic steps of bowel management. The Poo Game

Becoming independent

As children develop, they want to become more independent. This is a natural part of growing up. The same goes for the child’s toilet habits. When you feel your child is ready, you can start teaching them about going to the toilet and emptying their bowels.


The Poo Game

The Poo Game is a set of cards that you can use to teach your child how to empty their bowel. The cards can be used to play different fun games that can be adapted to suit age and skills. Simply print the cards, cut them out and you’re ready to play.

The Poo Game has been designed to help you and your child learn toilet habits in a fun way. It’s simple to use and as the child gets the hang of it, it’s easy to make it more challenging. Have fun!

Download playing cards (pdf, 1MB)
Download instructions (pdf, 1MB)


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Remember…

The Poo Game is meant as a training supplement, not to replace actual instructions for use. Consult a doctor or a nurse to get proper guidance or training in how to use the bowel flushing product you have chosen and always read the instructions.

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Better lifestyle, better bowels

Introducing relatively small changes to your lifestyle can help to reduce the symptoms of bowel dysfunction and ultimately make your bowels healthier. Better lifestyle - better bowels
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Getting a reliable bowel routine

Small changes you can make include: 

  • Eating healthier – a balanced diet that is high in fibre and water will help to reduce constipation. Eating lots of fresh fruit and vegetables and less red meat may help to protect against certain types of cancer
  • Stopping smoking – smoking can make the symptoms of inflammatory bowel conditions worse
  • Reducing your intake of alcohol
  • Reducing the use of certain medicines – a number of common medicines, such as those used to treat heartburn and indigestion, can cause diarrhea or constipation. It may also be possible to change the dosage of many prescription medicines
  • Exercising gently – gentle exercise helps to squeeze food along the digestive tract and reduces the risk of constipation

 

The importance of a bowel routine

One of the most effective changes you can make is having a reliable bowel routine when it comes to emptying your bowels.

This is to ensure:

  • Regular emptying of the bowel to prevent bowel leakage and chronic constipation.
  • Physical and mental well-being, so that you can get on with the daily activities that are important to you, whether it’s socializing, working, taking part in sports or traveling
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Contact Us

Questions about Peristeen?

If you have additional questions about Peristeen, please use the contact form below. A Peristeen Product Specialist will reach out to you by phone or by email. 

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Important Safety Information

Peristeen® empties the bowel by introducing water into the bowel using a rectal catheter. The anal irrigation procedure should always be carried out with care. Bowel perforation is an extremely rare, but serious and potentially lethal complication to anal irrigation and will require immediate admission to hospital, often requiring surgery. The risk information provided here is not comprehensive. To learn more, talk to your healthcare provider to understand the risks and benefits to determine if Peristeen is right for you. This treatment is prescribed by your physician. Although many patients benefit from the use of this device, results may vary. For further information, call Coloplast Corp. at 1-855-605-7594 and/or consult the company website at www.coloplast.us.

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