By Brigitte Collins, Head of Clinical Education
I am delighted to acknowledge the recent publication of an important article that brings much-needed clarity and consistency to the practice of rectal irrigation. This publication ‘Consensus on Safe Initiation and Monitoring of Transanal Irrigation to Optimize Adherence With Therapy’ (Emmanuel et al 2025), not only provides an updated and comprehensive overview of contraindications, but it also offers—for the first time—a clear definition of low and high volume irrigation. Specifically, low volume is now defined as 175 ml or less, and high volume as more than 175 ml. This distinction is an important step forward, enabling clinicians to more easily align the irrigation volume with a patient’s specific symptoms and clinical needs.
Particularly valuable is how this updated definition can be integrated into the digital decision guide. The inclusion of volume-specific guidance—where symptom checklists in the assessment process help guide toward low or high-volume options—is a practical improvement that supports more tailored and effective care planning.
The revised contraindications now categorised separately for low and high-volume therapies, have been received with great enthusiasm. This refinement is a significant asset for healthcare professionals, offering clearer clinical guidance and greater confidence in treatment planning.
What makes this article even more impactful is that it reflects a consensus from global key opinion leaders, lending it both authority and international relevance. This is especially timely for us as a company, as we are currently revising our Instructions for Use (IFU) to incorporate these updated contraindications, ensuring our materials remain clinically current and aligned with best practices.
Moreover, the article underscores the strong safety profile of rectal irrigation, supported by available safety data indicating a low rate of adverse events. At the same time, the authors emphasise the critical importance of specialist-led training at the outset of therapy to ensure safe and effective use—something we strongly support.
Congratulations to the authors on producing such a clear, practical, and evidence-informed resource. It is a significant contribution to the field and a valuable reference for all healthcare professionals involved in bowel management.
To read the full article, please visit: Consensus on Safe Initiation and Monitoring of Transanal Irrigation to Optimize Adherence With Therapy
