Use the Rome IV criteria to guide diagnosis of bowel disorders. According to the criteria, your patient must have two or more of the following in more than 25% of bowel movements to be diagnosed with chronic constipation and faecal incontinence³:

1. Straining
2. Hard or lumpy stools (Bristol Stool Form Types 1–2)
3. Sensation of incomplete evacuation
4. Sensation of anorectal blockage
5. Need for manual maneuvers to facilitate defecation
6. Fewer than three spontaneous bowel movements per week

To meet the criteria for faecal incontinence, the patient must have experienced involuntary bowel leakage for at least three months.⁴

Bowel disorder affects millions of people in many different ways.⁵ Some experience faecal incontinence, while others battle chronic constipation. The bowel treatment pyramid offers a structured approach to managing these conditions and some of the very first steps towards improvement can be changes in diet and lifestyle supplemented by medications (including oral and/or rectal laxatives, etc.).⁶
If nothing proves effective, transanal irrigation (TAI) should be introduced. TAI is designed to assist the evacuation of faeces from the rectum and/or distal colon by introducing water through the anus.⁷

How do you select the right solution for patients starting transanal irrigation? It needs to be simple to use and as gentle as possible. Comfort can also play a role when patients are introduced to TAI. A solution that feels soft and intuitive can help ease some of the perceived barriers at the start and make the process seem less daunting.
Select a catheter with a hydrophilic coating that doesn’t dry out. A catheter that remains coated helps patients have a smoother experience giving them the chance to proceed with irrigation at their own pace.