Ileal pouch irrigation: using intestinal hydrotherapy to manage bowel dysfunction

Ileal pouch irrigation is an emerging intestinal hydrotherapeutic technique designed to support individuals experiencing bowel dysfunction following restorative proctocolectomy with ileal pouch-anal anastomosis. This procedure involves instilling lukewarm water into the ileal pouch to facilitate controlled evacuation, offering patients greater predictability in bowel movements and a potential reduction in urgency, frequency, evacuation difficulties and incontinence. By promoting regular pouch emptying, irrigation may alleviate symptoms such as inflammation, bloating and incomplete evacuation. The intervention has shown promise in enhancing quality of life (QoL), restoring confidence, and reducing psychological distress associated with unpredictable pouch function. This article examines the clinical application of ileal pouch irrigation using a structured protocol, supported by ongoing follow-up to ensure the safe and effective integration of this procedure into patients' routines. Selected case studies demonstrate how targeted irrigation can significantly improve daily living for pouch patients, with outcomes assessed through patient-reported overall QoL improvements and satisfaction.