The Peristeen anal irrigation system from Coloplast is fairly new to the United States and is now FDA approved, but it has been used with success by people with spinal cord injuries and Spina Bifida in Europe for many years.
How it Works
This Peristeen Video by Coloplast explains how to use it. Also, Coloplast has ensured that healthcare professionals scattered all across the country are available to train individuals and parents on how it works. In fact, a formal training is required before one can use the product.
Benefits and Challenges
Peristeen was designed to allow a person to administer their own enema independently. Unlike the cone enema, the Peristeen is designed to inflate inside the rectum and stay put until deflated, reducing the need for help from a caregiver. Unlike the balloon enema, which is long and floppy and must be inflated with a syringe, the Peristeen’s short and stiff catheter is easier to insert and inflate independently. Further, the system does not require gravity to work, so a user can place the bag on the floor or a counter instead of hanging it up high. Many people try the Peristeen as a last-ditch effort toward independent bowel management before trying surgeries such as the MACE. If an older child, teen, or adult can administer the Peristeen independently, that prevents the need for a sometimes difficult surgery!
Many people say they prefer the Peristeen over other enema programs because they spend less time on the toilet each night. Unlike the cone or balloon enema programs, once the water from the Peristeen is pumped in, the balloon can be deflated immediately or after one minute instead of waiting 10 minutes.
Studies show that more stool is cleaned out from the rectum and descending colon with the Peristeen compared with traditional enemas. Although the Peristeen is designed to use plain tap water only, some people do have to try adding irritants such as glycerin or castile soap to get a better clean out.
Ideally the inflated catheter stays in place without being manually held, which is why the system works so well in the spinal cord injury population. However, low anal tone and patulous (wide open) anus are more common in the Spina Bifida population, and the catheter sometimes must be manually held in place. Unlike the balloon enema, for which the solution is to inflate the balloon more, the solution to this problem with the Peristeen is often to inflate the balloon less so that it can more naturally mold to fit the rectum. Even then it may just not work depending on the person’s anal sphincter tone. That can limit independence with the program, but some still prefer the device even with its limitations.
The biggest obstacle in starting a Peristeen program is actually getting the equipment supplied by a medical supply company and paid for by insurance. There are precious few supply companies in the U.S. that will provide this product, and it can take months or in some cases years to get it approved by insurance and supplies delivered. It is wise to have another bowel management program in place while you wait.
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