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Transanal irrigation (TAI), which has emerged as a therapy for patients with bowel dysfunction, can aid emptying of the bowel and help to re-establish control of bowel function by choosing the time and place of evacuation. Because of the ever-growing numbers of TAI systems available, choosing the optimal equipment can be overwhelming. Therefore, a consensus review of best practice from a working party of experts was thought to represent the most appropriate means of arriving at clinically meaningful advice. This led to the production of an article as well as a decision-guide booklet to aid choice of equipment, initiation, patient education, regimen setting and follow-up. These are designed to help healthcare providers initiating TAI to make optimal decisions for each individual patient.

Transanal irrigation (TAI) is a treatment for bowel dysfunction, with UK approval in patients with constipation and faecal incontinence. This article is intended for health-care professionals involved in the management of patients with bowel dysfunction and describes what TAI is and the proposed method of action. It also considers the latest evidence related to the safety and efficacy of TAI. There is now a potentially overwhelming range of equipment available on prescription to deliver this treatment. The factors to consider in the appropriate selection of equipment for individual patients will be considered, alongside an algorithm for the selection of equipment to aid health professionals with this choice.

Low anterior resection syndrome (LARS) is a collection of symptoms that can occur as a result of a low anterior resection for bowel cancer. Transanal irrigation (TAI) can be used to manage these symptoms. This article describes a retrospective audit of 15 patients who were using TAI to manage symptoms of LARS. The aim of the audit was to ascertain whether the use of TAI improved outcomes for these patients. The data suggest that TAI has reduced both the frequency of bowel movements and episodes of faecal incontinence. Those patients using higher volumes of water seem to have experienced more benefit than those patients using lower volumes of water. These findings are consistent with current literature around TAI for LARS and suggest research into optimum volume of water would be beneficial.

Details of a 22-item questionnaire used to assess the result of surgery for peptic ulcer are given. Tested in 47 patients the questionnaire correlates well with the Visick grading. The 100-mm line test and post-operative alkali consumption are less accurate measures of outcome. As an alternative to the Follow-Up Clinic, as a potential predictor of result, and as an indicator of the quality of life, the questionnaire has much to offer.