SRS381 - Trans-anal irrigation for defaecatory disorders: results from a tertiary care institution

Abstract Trans-anal irrigation (TAI) is recommended in patients with defaecatory disorders refractory to preliminary conservative treatment. Our aim is to determine the outcome of using low-volume (LVI) versus high-volume (HVI) irrigation these patients. Data was collected from 2016 to 2021 using a prospectively maintained database for socio-demographics, presenting complaints, investigations, type of irrigation, complications, and improvement in symptoms. TAI was initiated in 449 patients with female predominance (89.1%). The most common ethnicity was White British (60.7%) and presenting complaint was constipation (55.6%). LVI was used by 307 and HVI by 142 patients. Improvement in symptoms was reported by two-thirds of patients in both groups. 29% of patients switched irrigation where patients with constipation were more likely to switch from LVI to HVI, P-value 0.030. Patients using LVI were more likely to have rectal hypersensitivity while those using HVI had rectal hyposensitivity, P-value of 0.005. One-fifth of patients reported complications in both groups where technical difficulties, rectal bleeding, and leakage were associated with LVI while abdominal pain, bloating, and anal pain with HVI, P-value 0.036. TAI is a safe way to manage defaecatory difficulties with satisfactory improvement in symptoms. Side effects associated are not minimal, however with good training and robust in community follow-up, patients can continue to be compliant. Future prospective studies are needed to compare both types of irrigation to ascertain if either is superior for a particular pathology, so patients do not have to switch between them, and barriers to TAI with reasons for discontinuation need to be explored.