Ask the Nurse

Posts in this section can only be replied to by the nurses. If you wish other users to respond to your question you will need to post it in another topic on the forum as well.


Peristeen transanal irrigation system [ Bowel Motions don't stop part 3]

Basically a follow up to my Bowel Motions don't stop posts describing my tribulations following my low anterior resection of upper rectum and sigmoid colon and a temporary ileostomy reversal which went wrong due to adhesions and scar tissue leading to a further small bowel resection and further anastimosis .
There then followed a series of strictureplasties 6 in all to stretch the original anastimosis. Diameter finally settled at around 18mm and it was decided that any further attempts would result in further scar tissue formation which would be counterproductive. Since then bowel motions have been kept soft with the regular use of movicol once a day and a degree of stability achieved. Unfortunately over the last few months I have become aware of further scarring which has developed at the anastimosis site on one side. This has resulted in everything slowing down again despite me trying to keep all bowel motions the consistency of toothpaste! My GP now tells me my anastimosis is now a bit like an S bend and its this thats causing the problem. She suggests that over a period of a few days despite me continuing to pass some stool things begin to back up leading to my current distressing symptoms. Her suggestion was to employ more movicol but because my diet is restricted anyway this seems to make me feel quite ill unlike in the past. The other alternative would be perhaps to use some form of anal irrigation system to prevent any build up. My question is whether this has proved useful to others with a low resection experiencing slow transit and build up problems? Perhaps its not appropriate for rectal anastimosis patients?
all the best

Charlotte Nurse Advisor


Rectal or anal irrigation is increasingly being used in patients following rectal cancer surgery. It can help to achieve a satisfactory bowel action and regulate the bowel activity.

The problem with you may be the narrowness of the stricture at the anastomosis. I would definitely talk to your nurse specialist who can refer you to someone who specialises in irrigation (if he or she doesn't) to talk through whether irrigation is a possible method of bowel management for you.

With kindest regards,



Thank you Charlotte, for your rapid reply to my enquiry. My GP is to make further enquiries on my behalf to see if the technique is appropriate to my particular case or whether the low anastimosis would preclude its use. I will post my enquiry in the general forum to give it a wider audience to see if anyone else has found the technique useful?


Just an update to the Peristeen Saga --- FINALLY been referred to colorectal nurse team in another hospital some 30 miles away for assessment as to whether anal irrigation would be suitable for my problems --- but only after lobbying my GP on and off for 3 months. Unfortunately in the meantime I have developed a rather alarming set of symptoms whereby after a couple of days of difficulty passing bowel motions I'm waking up in the middle of the night with elevated heart rate/shivering/ shaking and feeling generally unwell-- only relieved by "getting vertical " and walking about a bit. This means loosing a lot of sleep and very little appetite. Sometimes for no apparent reason- bowels open and I get evacuated many times- its as if there's a backlog which gives these alarming symptoms only relieved with the bowels opening. Wonder if anyone else has experienced these sort of alarming symptoms while lying down? Maybe I should start a new topic ?

Jane SH Nurse Advisor

Thank you for your post and your personal update which I read with interest.
Please discuss this with your nurse specialist/ medical team caring for you. Your comprehensive notes will be very useful and together you can explore all available treatment and bowel management options.

You may also like to post this in another topic on the Forum as well?

with very best wishes
Jane SH


Thanks for your prompt reply. I will endeavour to contact my colorectal nursing team tomorrow to see if they can shed more light on these rather alarming symptoms.
I am wondering if I have become anaemic after a long time on a restricted diet.