Trans Anal Irrigation - coloplast.co.uk

Trans Anal Irrigation - Starting your patient on Peristeen 24 November, 2015 What do you need to get started? Peristeen system code 29121 Accessory unit code 29122 Coloplast Care patient start pack (Patient guide, step by step guide, DVD) 24 November, 2015

Getting Started Teaching Ensure you have all equipment to hand register patient with Charter Healthcare Ensure patient is not impacted Patients can be taught in clinic or home setting Ideally first irrigation will be done with health care professional present 500ml is an ideal amount to begin irrigating with for adults Irrigate daily for first two weeks to ensure good technique and identify individual regime Follow up in person or via telephone within 7 -14 days 24 November, 2015

Parameters to be adjusted individually: Size of catheter Balloon Volume of water Frequency of irrigation Medication Any changes in the procedure must be done gradually Only change one parameter at a time 24 November, 2015 Parameters to adjust individually - catheter

Insert the catheter to the handle Start inflating the balloon with 1-2 pumps Balloon must be inflated above sphincters Adjust the number of pumps in case of leakage of water during the procedure Patients with flaccid bowels may need 3-4 pumps Minimum number of pumps should be tried out to avoid triggering of reflexes

Do not inflate with more than 5 pumps (2 pumps for small catheter) 24 November, 2015 Parameters to adjust individually - volume of water Water should be body temperature 36 - 38 C Adults start with about 500 ml water Children should start with 200-300 ml water

24 November, 2015 Parameters to adjust individually - volume of water Increase gradually the amount of water until the patient achieves a good and complete emptying Effect achieved: Faecal incontinence When patient has no faecal incontinence episodes between irrigations Constipation When patient has regular bowel evacuations and emptying results after irrigation

When symptoms as bloating are reduced or disappear 24 November, 2015 Parameters to adjust individually - frequency and timing Do the irrigation every day in the beginning Do the procedure at regular intervals at the same time and fit it in to the daily routine. Natural bowel movements are strongest in the morning after a meal. Some patients need to irrigate daily, others every other day

depending on thier transit times It is important to irrigate regularly and not occasionally to achieve the optimal results 24 November, 2015 How do we ensure successful use of Peristeen? New users of Peristeen should expect a period in which to adapt and optimise the irrigation regime to their individual needs Parameters to adjust Balloon size

Frequency Water volume Medication Early difficulties are mainly attributed to practical problems Follow up by the HCP is critical 24 November, 2015