How to increase compliance in Transanal Irrigation (TAI)
One of the biggest issues with Transanal Irrigation (TAI) is that many users quit too early – before the therapy has had a chance to be effective.
Once established this therapy shows great results. It’s not a quick fix, but a process, and both patients and healthcare professionals need to be aware of that when starting with TAI.
We asked two bowel management experts to share their views on how to increase compliance in TAI.
Guiseppe Preziosi’s conclusions to optimize adherence is:
You should select your patients carefully, and focus on how to engage and train them.
The treatment should be tailored for each individual, in terms of frequency, water amount and balloon volume etc.
It’s important to choose the right device; one that suits the patient and allows for individualization of the therapy.
To achieve the above it’s of great value if the device helps monitor the progress.
Gabriele Bazzocchi focuses on the science behind transanal irrigation (TAI); the peristaltic movements and pressure. He shows results from his experiments, measuring pressure in the colon during TAI and also water pressure and balloon pressure under different conditions. This study was a comparison between TAI devices with manual and/or electronic pump.
Among the devices equipped with a manual pump, the main difference in terms of safety is the presence of a valve on the water storage bag cover. This valve opens when pressure exceeds potentially hazardous values for the colon1.
An electronic pump guarantees low and constant air flow which allows the balloon to reach the right size with lower pressure inside, permitting better adaptability. This is a safe way to inflate the catheter balloon in TAI in SCI patients.2
An electronic device is precise and independent from the manual pumping characteristics and may offer further chances of preventing any improper use of the irrigation system2.
1. Bazzocchi G, Poletti E, Musco S. ISCoS annual meeting. 2016:Abstract 109.
2. Bazzocchi G, Musco S, Landi L. ISCoS annual meeting. 2016:Abstract 83.