Clinical Study

journal-cover-g-and-hColon Irrigation – A Useful Alternative in Management of Constipation

Journal of Gastroenterology and Hepatology

September 2010 – Vol 25 Suppl 2
by Dr. Sylvester Yong


Constipation remains a challenging clinical problem. Current management options remain unsatisfactory especially in chronic cases. Colon irrigation is a simple and useful procedure that addresses the patho-physiology underlying constipation. Clinical studies to define its therapeutic potential in the management of constipation should be encouraged.


The management of constipation remains a challenge in clinical practice. Prescription medicine such as the use of laxatives and bulking agents offers some level of relief but are not always effective. Treatment options in chronic cases include biofeedback therapy, colonic lavage and manual evacuation. These too offer only limited and unsatisfactory results1.

Colonic irrigation using different approaches have been demonstrated to be useful in the treatment of functional constipation234 and various bowel related problems56. The procedure infuses water into the colon to facilitate the evacuation of bowel contents. Water hydrates (soften and loosen) bowel contents and activates peristaltic activity resulting in spontaneous bowel movement and evacuation of bowel contents. Although not regularly recommended, studies have demonstrated the beneficial effects of colonic washout in the treatment of constipation and faecal incontinence789.

With the availability of modern instruments incorporating safety designs that meets F.D.A. guidelines, a more serious look at colonic irrigation as a useful alternative in management of constipation should be considered. Design of instrument also provide for the observation of the discharging waste and offers a more objective means of assessing the outcome of therapy.

In this paper, the results of patients suffering from chronic constipation who have not responded satisfactorily to conventional therapy and had colonic irrigation carried out on them are reported. In the majority of cases, symptomatic relief and improvement were noted. Details of the procedure and the rationale for recommending the procedure will be discussed.


Colonic irrigation can be a useful alternative in the management of constipation. It is a simple procedure yet its therapeutic potential remains unexplored. Clinical studies should be undertaken to ascertain the safety and efficacy of the procedure and to consider its use as an alternative option in the management of constipation.

  1. J. F. Johanson; J. Kralstein. Alimentary Pharmacology & Therapeutics. 2007; Pg 25(5):599-608. Chronic Constipation: A Survey of the Patient Perspective 

  2. Gardiner A, Marshall J, Duthie G. Nurs Stand. 2004 Nov 10-16;19(9):39-42. Rectal irrigation for relief of functional bowel disorders. 

  3. Tod AM, et al. Br J Nurs. 2007 Jul 26-Aug 8;16(14):858-64. Rectal irrigation in the management of functional bowel disorders: a review. 

  4. McWilliams D. Nurs Standard. 2010 Mar 3-9;24(26):42-7. Rectal irrigation for patients with functional bowel disorders. 

  5. Koch SM, et al. Int J Colorectal Dis. 2009 Sep;24(9):1019-22. Retrograde colonic irrigation for faecal incontinence after low anterior resection 

  6. Sacha M. Koch et al. Colonic irrigation for defecation disorders after dynamic disorders after dynamic graciloplasty Int J Colorectal Dis (2008) 32:195-200. 

  7. Christensen P, et al. Dis Colon Rectum. 2009 Feb; 52(2):286-92. Long-term outcome and safety of transanal irrigation for constipation and fecal incontinence. 

  8. Faaborg PM, et al. Colorectal Dis. 2010 Jan. Anorectal function after long-term transanal colonic irrigation. 

  9. Christensen P, et al. Dis Colon Rectum. 2003 Jan;46(1):68-76. Scientific assessment of retrograde colonic washout in fecal Incontinence & constipation.