# Constipated? This really does work......



## idkwia (Feb 26, 2009)

The Peristeen Trans Anal Irrigation System which is something that certain disabled people use to empty their bowels really does work. I know that everyone is different but this is definitely worth a try. If is also a bit of a faff to use it but if it works for you then is worth it and of course drug free.


----------



## annie7 (Aug 16, 2002)

oh yes, i've read/heard a lot of good things about peristeen.

i wish it were available in the usa. i did read something awhile ago about maybe it will become available here next year--fingers crossed! i have sent coloplast an e-mail asking about shipment and availability to the usa. hopefully i'll get an answer soon.

here is an updated link to the peristeen system.

http://www.coloplast.co.uk/Peristeen-Anal-Irrigation-System-en-gb.aspx


----------



## harmoiny (Jan 3, 2012)

Wow! I reviewed info, thank you for sharing this "urgently needed" product... Some real help and "drug free"! Awesome... I want my life back 2... suffering since 1996. This seems to be just the answer for those like me... I'm getting in touch with them 2 via email, phone... I will go to the source if necessary... I pray politics don't get in the way of distribution in USA.


----------



## sstorm7 (Nov 15, 2000)

I ordered this system from Australian Home Nursing Supplies (http://www.ahns.com.au) a few years ago and had it delivered to the U.S. with no problems. YMMV. Peristeen didn't work for me though.


----------



## annie7 (Aug 16, 2002)

sstorm--thanks for the link. i e-mailed them and they replied, saying they do ship to the usa and the price of the started kit is $189. AUD with shipping costs to the usa of $30.00 AUD.

sorry it didn't work for you. actually i'm a bit doubtful it will work for me either. i have colonic inertia (failed sitz marker), a rectocele and a twisted colon. the regular quart size enemas no longer work for me. i always end up retaining a lot of the water--it gets trapped inside and won't come out until the next day after i take a stimulant laxative. fleets enemas don't get up there high enough to work.

once peristeen comes to the usa, i'll give it a go--hopefully it'll be covered by insurance. right now, ordering from OZ is a bit pricey for me.

don't think i'll be ordering from coloplast either, at this point. thanks again.


----------



## idkwia (Feb 26, 2009)

The thing about the Persiteen is that you can decide how much water to put in. I put in about a litre and I do this twice in order to empty properly. If I put in less than that then it is not effective for me, I understand that most people use about 700mls twice and others need to use less. I should say that to use this is a lot easier than using the normal type of enema you might have seen. The reason it works is because the water promotes peristalsis and because the water is ultra slippery and also dilutes the faeces it allows easy evacuation and without drugs just normal tap water.


----------



## oceannir (Mar 6, 2012)

idkwia said:


> The thing about the Persiteen is that you can decide how much water to put in. I put in about a litre and I do this twice in order to empty properly. If I put in less than that then it is not effective for me, I understand that most people use about 700mls twice and others need to use less. I should say that to use this is a lot easier than using the normal type of enema you might have seen. The reason it works is because the water promotes peristalsis and because the water is ultra slippery and also dilutes the faeces it allows easy evacuation and without drugs just normal tap water.


How long have you been using it for? Has it made anything lazier down there?


----------



## idkwia (Feb 26, 2009)

oceannir said:


> How long have you been using it for? Has it made anything lazier down there?


 I have been using the Peristeen for about 5 months and it has not made things lazier at all. This really does work and I am amazed that more people have not joined this thread.


----------



## idkwia (Feb 26, 2009)

I really have to bump this thread because more people need to know about this so I hope the moderators will allow it please.

If you are constipated or just fed up using drugs to make you go to the toilet then this system could change your life.


----------



## annie7 (Aug 16, 2002)

i'm bumping this thread up...

an update on peristeen availability in the usa

i recently got an e-mail from a coloplast rep which said something about the recent fda approval for peristeen in the usa. but it sounded like so far peristeen is available only for people who have disabilities and are working with a rehab center and qualify for medicare (none of which includes me). anyway--here's a copy of that e-mail and the coloplast rep's contact info if anyone is interested:

Thank you for calling us
at Coloplast to request information about Peristeen. This is a great product
and I hope to be a resource as you determine if you are interested. Talking to
your rehab doctor or urologist is the first step to seeing if you are "a good
candidate". The criteria for use is primarily for managing neurogenic bowel
conditions like Spina Bifida, spinal cord injury or MS. Also, to ensure
success, clinicians determine that there are no "contraindications" for use.

If your rehab doctor
does recommend that you pursue it, then we would need to see if you can be
supplied with Peristeen. This is a question based on reimbursement. We are
early in the process of providing it in the US, so, there are a few limits at
this point.. We have just received FDA approval for the full system and are now
working to get national coverage in the US. It will take time to obtain a
"reimbursement code" which is required in the US for people who have Medicare to
get it. People who have Medicaid or private insurance are better positioned for
reimbursement at this point. We work closely with suppliers who specialize in
helping patients get approval for products that are new in the US.

If your doctor gives you
the OK to pursue it, we can check what established training center would be
available to you. The staff at the training center do a thorough assessment to
ensure that Peristeen would be a good choice. Then, you would need training
with a Peristeen nurse. This process takes some time and patience, but, we'll
work together for you. It always helps to speed up the process of getting
training in your area if the physician or nurse in your rehab center is getting
request

At your convenience,
please let me know if you are interested in Peristeen and what rehab center(s)
you have worked with. We should start with gathering information such as your
physician recommending you as a potential candidate and insurance.

Thank you again for
contacting us and we hope to be a resource for you in any way needed.

Warm
Regards,

Rita Ward,
RN, BS, MA

Consumer
Care Advisor

Coloplast
Corporation

1601 West River
Road

Minneapolis, MN
55411

[email protected]

Direct:
612-337-7856

Toll
free:1-888-726-7872


----------



## annie7 (Aug 16, 2002)

another update-

just got the following e-mail from the coloplast rep (i'd written her back regarding usa availability):

Thank you for your
note back. Yes, people in the UK can use it without our initial criteria in the
US that it has to be a Neurogenic Bowel condition. Hopefully, that will be the
course that Peristeen takes in the US as well. I hope that you find a good
alternative very soon. Let's keep in touch and please check in with us at
Coloplast anytime to see what the status is of Peristeen. It will take about a
year to get it approved through Medicare and that will also have limits on the
diagnosis for starters. Thank you again and take care,
Rita


----------



## Jeran (Apr 1, 2013)

How is this any different than a simple water bag enema we could buy at a local drugstore for $16?


----------



## idkwia (Feb 26, 2009)

It is different because it has a pump and so does not rely on gravity as you use your hand to work the pump. You can also get a lot more water in than by using an enema. It is much much better than a normal enema.


----------



## idkwia (Feb 26, 2009)

Update: - I have been using this Peristeen system for almost 2 years now and it is brilliant. Previously I had tried numerous laxatives and diets etc but this is by far the best thing by a long way. Of course everyone is different and maybe not everyone will respond but you have to experiment with this to find the best way for you. Personally I use 1.8 litres of water twice to empty. The instructions say between 700mls to 1litre but this was not enough for me.

If you suffer from constipation do not ignore this system.


----------



## Aidara (May 9, 2014)

Idkwia, has gp prescribed it for you? Has it been it difficult to get it prescribed? I can't get anything else apart of Miralax and fybogel on my prescription.


----------



## idkwia (Feb 26, 2009)

Aidara - It was originally prescribed by a gastroenterologist and now my GP gives me repeat prescriptions.


----------



## Aidara (May 9, 2014)

Idkwia, what are your diagnosis? How did you get your diagnosis? I am struggling so much, because my gp doesn't want to do any testing on me, he keeps prescribing me fybogel and Movicol and says to take them for the rest of my life. It stopped working and I don't know what else to take. I am concerned that there also might be some explanation for my constipation, other rhen chronic constipation. My request to see gastroenterologist was rejected twice. I would feel so much better if my symptoms was taken more seriously and properly investigated.


----------



## idkwia (Feb 26, 2009)

Aidara, if you are not happy with the service you are getting from your GP then you need to tell him/her and or find another GP.


----------



## Sean (Feb 8, 1999)

Idkwia, how often do you use the Peristeen system? Is it something that you do every day?


----------



## Dreamcatcher32 (Nov 12, 2013)

annie7 said:


> another update-
> 
> just got the following e-mail from the coloplast rep (i'd written her back regarding usa availability):
> 
> ...


I'm really glad you checked into this Annie. I think it's important for everyone to really consider exactly why they don't allow this system for those that aren't diagnosed specifically with a Neurogenic Bowel condition. I'd wager there is good medical reasoning for this.

For those that are diagnosed with Pelvic Floor Dyssynergia, it might be quite uncomfortable. I was told at Mayo Clinic that even enemas can be uncomfortable because those with PFD are not able to fully evacuate water out. So it stays inside and causes all sorts of problems. I found this to be true in my case and the enemas only seemed to make my IBS and pelvic floor problems worse. (though I can 'handle' enemas better now - since getting (and continuing) the bowel retraining at Mayo Clinic)

Those who suspect PFD or have been diagnosed might feel more comfortable using powerful suppositories (Dulcolax, Magic bullet, etc) than enemas or peristeen. I was told that for those that have slow transit, it's best to take a laxative the night prior and in the morning, use a suppository. Then you're 'working' both ends. I have also heard of Enameez but again, I think most who use these have Nuerogenic Bowel Conditions. You can buy them on Amazon, though. Again... would be very cautious if you have a pelvic floor problem.


----------



## idkwia (Feb 26, 2009)

Hi Sean, yes I use it every day, but some people use it every 2 or 3 days. As we know, everyone is very different and what works for some may not work for someone else. This is the only thing that I have come across that works for me. If you can manage your problem with more cheaper and simpler methods then do so.

Good luck.


----------



## annie7 (Aug 16, 2002)

with the regular enemas i've always had problems getting all the enema water out in a timely fashion because my colon just doesn't work very well..slow transit..

i'd still like to try peristeen though. it sounds much more effective than an enema.


----------



## tummyrumbles (Aug 14, 2005)

These topics have some good common sense advice:

http://www.ibsgroup.org/forums/topic/135351-colonic-irrigation/

http://www.ibsgroup.org/forums/topic/155535-colon-hydrotherapy-colonic/

The procedure may become addictive, in that short-term relief may cause you to keep using it but the underlying reasons aren't being addressed.

There is also a risk of bowel perforation.

http://www.aca.uk.com/documents/MedicalAlertPeristeen.pdf

What does really work, and is a genuine cure for me, is a lack of gassy stool / gas in the colon. It could be that gassy stool is difficult for the peristaltic action to move through and it could be that pockets of gas impede the progress of stool as well. Constipation is usually associated with gas in IBS.

A low flatulogenic diet is very, very tough but needs to be tried for at least one or two days to see if there's any benefit. Constipation may not be due to a mechanical fault in the colon! I believed this for 10 years and did nothing about my diet. This meant hours-long evacuations and continuing depression. It's too easy to jump to the wrong conclusion.

Lunch is the hardest meal of the day for me as this is when I crave toast. Toasted jaffles seem to have a lower gas factor than bread and the reason could be dextrinisation, where heating breaks starch down into simpler sugars which are more easily digested. It would be better if you didn't eat wheat at all, but if you have to a toasted, steamed jaffle with ham and tomato might be a good option.

Dinner is easier for me as it's usually just meat or fish or eggs with boiled low FODMAP vegetables - usually potato, pumpkin, carrot, zucchini, green beans. Fruit is any citrus and banana (low starch if very ripe).

I had a ten minute evacuation yesterday morning from following this diet yesterday. Dinner was 6.30 pm and this helps too. I had to give up fish and chips for lunch which I love. I didn't realise how starchy both the fish and chips were. Starch seems to be my biggest problem over high FODMAPs although these cause gas as well.

The problem is the lower the starch content of a carbohydrate usually the higher the fibre level. You need to experiment to find higher fibre foods that are tolerable but it's easy to be led astray. Even though foods like sweet corn might give you gas, for me it's fairly short lived. The worst foods in terms of gas that seems never-ending might be the starches. This makes sense as fibre isn't really food; it's non-digestible, even for bacteria. Starch is digestible food, and bacteria love it as much as we do. We need to eat starch, but we don't need to eat high-starch foods, which mostly tend to be manufactured from grains.


----------



## Sean (Feb 8, 1999)

Thanks for the response, idkwia. I would definitely be willing to try it if it were available in the USA. Large volume water enemas do not work that well for me any more. I don't get great results consistently, and, like Annie experienced, a lot of the water gets trapped inside of me and will not come out with the evacuation. I would guess that the Peristeen with the pump action would be more effective.


----------



## idkwia (Feb 26, 2009)

Hi Sean. Yes I understand. None of the ways of managing our conditions are great and we are all looking for something that works for us with the least amount of fuss. This is the only thing that has worked for me and I know it works for others but not everyone. I am simply sharing it so that others might consider it.

I have found that the reason the water seems stuck is because there is still stool there. So once I am sure that nothing more is going to come out I put more water in and this then usually brings everything out. Sometimes some water is left behind but that it ok because the bowel is designed to absorb water not expel it unless there is a lot of it. I have found that the water lubricates everything and helps move things along as well as distending the bowel to make it work.

Just to be clear, this clears me out completely and has done every day for a long time now. And I can eat whatever I want and whenever I want.

PS You use this on yourself and there is no chance of penetrating the bowel unless you go horse riding with the catheter in situ or something equally as stupid.


----------



## annie7 (Aug 16, 2002)

Idkwia---thanks for all your information--appreciate it! and so glad peristeen is working so well for you--that's terrific!


----------



## flossy (Dec 8, 2012)

The Peristeen looks somewhat interesting - I guess - but to be honest it seems like a glorified and somewhat pricey (155 dollars!) enema bag.

Here is the video:


----------



## idkwia (Feb 26, 2009)

Flossy - it is quite a lot different from an enema. If you are constipated an enema using gravity will not get any further than the stool in your colon whereas this uses a hand squeeze air pump which delivers the water much quicker and much further and so breaks down the stool and gets it moving. Also the catheter will not fall out under pressure like it might with an enema bag because the catheter has a small balloon that you inflate with the pump that stops it coming out.

The Peristeen is not cheap and the spares you need to get are also not cheap but if it means me missing a weeks' holiday a year to be in a huge amount of less discomfort for the other 51 weeks then I know which option I would take.


----------



## flossy (Dec 8, 2012)

I know what you're sayin'. Thanks for the info.


----------



## Aidara (May 9, 2014)

Idkwia, is Persiteen safe as a long term treatment? Would it loose its effectiveness over time as other laxatives do? How much does it roughly cost? You mentioned you get repeat prescriptions from your gp, what are you paying for then?

Also, they say enemas are not safe to use regulary, what makes Persiteen safe to use everyday?

Do you think it would be suitable for me to use as you know my symptoms? Thank you.


----------



## idkwia (Feb 26, 2009)

Aidara,

I have used it for 2 years and it works the same as ever. However I know someone else who it lost its effectiveness for.

I pay nothing as I am in the NHS. I mentioned cost for those poor souls in other countries that have to pay for their healthcare.

Who says enemas aren't safe to use everyday and where is their scientific evidence? Many disabled people use the Peristeen every day for life.

I think it may work for you but the only way to know is to try. I have no idea if it would work for you better than your current protocol.

You did not reply to my last PM, did you see it?


----------



## rewinj (Apr 19, 2012)

bumping this because there has been a fair amount of talk about rectal irrigation, incomplete evacuation, and pelvic floor abnormalities lately...


----------



## Nuffa (Sep 12, 2014)

Just in case u would like to know. Two days ago someone with colonic inertia highy recommended peristeen to me.


----------



## Aidara (May 9, 2014)

I have started using Persiteen. Unfortunetaly, it doesn't work well on me.. I was told to start with 500ml of water. I have an urge to go after using it, but I pass water only. In fact, I feel even worse after using it as some of the water gets trapped in my rectum as usually stool does. If I use suppository stool and water would come out. I can't do more then 500ml, because I can't hold more then that. Going to see my colorectal nurse soon, hope she will give me some advice on it. I really desperate for it to work as my next step would be surgery. I am diagnosed with intussuscepton and rectocele.


----------



## idkwia (Feb 26, 2009)

Aidara, using 500ml is nowhere near enough. I have been using the Peristeen for 2.5 years and have experimented a lot with it to find its ideal way of operating. It is likely that your intussusception stops stool getting into the rectum and so 500ml will not reach higher than the rectum where you need to get to. You have to get use to a bit of discomfort to get it higher than that but you will realise that more water will go in. The main reason it will not go in is because the stool in your sigmoid is stopping it.

I fill the bag completely which is 1800ml and put that in. If it becomes to uncomfortable to put it in then stop and let what you have in there out. Keep repeating the process and more stool will come out. You will know the rectum and sigmoid is empty when it is pretty easy to get 1800ml in. For the record, I put 4 x 1800ml in each time I use it. I empty the first 1800ml from my bowel first and then put the next bag in.

If your rectum is empty then 500ml will fill it, but of course only water will come out. You have to get higher. This is basically what colonic irrigation does but of course they put even more than 1800ml in. My colorectal nurse told me the same as yours but she was completely wrong as she would have been trained by Peristeen who think they are treating people who are paralysed who just need to empty their rectum. Their situation is different from those who have prolapses.


----------



## Aidara (May 9, 2014)

Idkwia , thank you so much for your response. I keep experimenting with Peristeen these days. I try to put at least 800ml of water and it gives me a bit better result, still not perfect though. However, I keep trying to put in as much water as I can. I will post later how I am getting on with irrigation. Thank you for your help.


----------



## Aidara (May 9, 2014)

Also, I am so scared about bowel perforation when using this product. When is the risk of that - when insertng a catheter or when pumping the water? Any tips how to prevent that as my nurse doesn't seem to be very knowledgeable.


----------



## idkwia (Feb 26, 2009)

Aidara as you know the catheter is not much wider than a pencil and nowhere near as wide as stool itself, it is also not very long so there is no risk of perforating the bowel as you can feel it go in and your pain sensors would tell you if you were pushing against the bowel wall too much. If you want a bit more reassurance then I use a normal moisturising cream on the catheter and the anus which makes everything much smoother when inserting. As far as the water the being a danger to perforation then there is no chance of that happening.

Pleased to hear you are getting a better result with 800mls but it is nowhere near enough. Get as much in as you can and then let it empty. Once it has emptied then do it again and you should be able to get more in and then do it again. You will know when the sigmoid and rectum are empty when you can get the whole bag in fairly easily. What I have described is basically how the professional places that do colonic irrigations do it - they put in as much water as they can then let it out and then do it again until they can reach the whole of the bowel, in our case we are only getting to probably around the top of the descending colon. You would probably be better off to go and see a reputable colonic irrigationist as they would be much more knowledgeable than your nurse. In fact, why don't you let them irrigate you and then you will feel the full results.

In short Aidara, all you are doing is washing your colon with water in the same way as you wash anything with water! Good luck.


----------



## QuietDesperation (Jan 17, 2014)

I've been using rectal irrigation for about 8 months. It works great. Once I have emptied I don't have to worry about a bowel movement for 1-2 days. I try to use all the water in the bag (about 1 liter) and that works well for me. If I use less then it doesn't work as good. With Persisteen I'm able to empty completely and that takes away the bloating and pain that can be assosicated with constipation. I do tend to get some gas though, and the process of irrigation itself is one that I find uncomfortable, time consuming and boring. I do it a few times per week, or whenever I feel like I'm getting too constipated again. I'm happy that there is such a thing as rectal irrigation, it helps me now. But I hope I won't need to do this for the rest of my life.


----------



## flossy (Dec 8, 2012)

More info, PDF format:

http://www.stmarksfoundation.org/uploads/docs/patientinformationleaflets/CV411N%20LRes%20(2).pdf


----------



## Aidara (May 9, 2014)

Thank you, Idkwia. Putting more water makes sense, but it is not that easy. I will try to get as much water in as I can and then let it empty as you suggested. I can't do more then 500ml at once. But once I managed to do 700ml in one go and had quite a good result. How do you manage to do 1800ml four times? How long does it take? Do you do irrigation everyday? Do you still take any laxatives? I am praying for Peristeen to work as my condition is getting rapidly worse and nothing is helping anymore, this product is my last hope..


----------



## Aidara (May 9, 2014)

One more question - would Peristeen work better if I try to hold water in for some time before passing it? When using plain water enema it is recommended to hold it for at least five minutes, would this strategy help with Peristeen?


----------



## idkwia (Feb 26, 2009)

Aidara, before I can answer your question in full I would like to know why you feel you cannot get more than 500ml in, what happens when you try?


----------



## Aidara (May 9, 2014)

I get very strong urge to go and cramps.I think I might be able to ignore that, but my nurse has made it clear, that I should avoid any discomfort, so I don't force myself to hold it. Should I keep the water inside even though I have strong urge to pass it?


----------



## idkwia (Feb 26, 2009)

Aidara, the fact that you get a strong urge to go is good, that is what your rectum is supposed to do and shows it is working properly. But, the issue we both have is that faeces cannot get into the rectum. If it was in the rectum then we could evacuate it. So you have to try and override it and get the water above the rectum into the sigmoid. It will feel uncomfortable and a little painful but generally once you have got past the internal sphincter it will get better. BUT, if the water hits faeces it will again feel uncomfortable and so you must try to get past it; if it gets too much to bear then let the water out and try again.

Take no notice of the nurse, they don't know what they are talking about in the field. The Peristeen was designed for paraplegics whose rectum's fill as normal but they cannot empty because they are paralysed. So that is why the nurses will say to put in 500ml or so to fill the rectum as that is the advice given in the 'book' but as I said, in our case our problem is getting stool into the rectum.

I have been experimenting with this for over 2 years' now and I have learned by trial and error the way it works. You need to do the same, but as I say try and think about aiming to get the water past the sigmoid.

I would strongly recommend that you have colonic irrigation done by a reputable place with a lot of experience as this will demonstrate to you how the Peristeen can work even though they will probably have no knowledge of the Peristeen themselves. it is for you to experience the filling and emptying process with each new filling getting further and further round the bowel.

Btw, I don't use any laxatives as they have no effect on me. Laxatives are designed to make the bowel work - my bowel works already but there is some sort of obstruction.

Also, consider reducing your fibre intake as much as possible. More fibre means more waste = more constipation!


----------

