NICE, the National Institute for Health and Care Excellence, have published medical technology guidance supporting the use of an irrigation device for treating constipation and faecal incontinence. 

Peristeen is a transanal irrigation system manufactured by Coloplast which can be used by children and adults and has been shown to improve bowel emptying minimising the risk of involuntary soiling. 

According to NICE, the case for adopting Peristeen for transanal irrigation in people with bowel dysfunction is supported by the evidence.

The key recommendations in the NICE guidance are as follows:

• Peristeen can reduce the severity of constipation and incontinence, improve quality of life and promote independence. 

• Peristeen is most effective when it is offered with specialist training for users, carers and NHS staff, and dedicated patient support. It may not be suitable for all people with bowel dysfunction and may take several weeks before a person is comfortable with using Peristeen, and some people may choose to stop using it. 

• Peristeen provides additional clinical benefits for patients and the NHS at no additional cost than standard bowel care.

Welcome news for patients

Brenda Cheer, Paediatric Specialist Continence Nurse and ERIC's nurse said: “At ERIC we are well aware of the enormous benefit TAI systems offer to children and young people. No child should have to suffer from ongoing faecal soiling; if laxatives and regular, effective toileting do not prevent it then they should be offered a rectal intervention.

No child should have to suffer from ongoing faecal soiling; if laxatives and regular, effective toileting do not prevent it then they should be offered a rectal intervention. 

This new NICE guidance will help to spread that message more widely. It will add credibility to the prescription of Peristeen both for long term conditions and for those that require it temporarily to enable the bowel to rehabilitate. TAI is well tolerated by children and young people; we should not shy away from its use.”

Simon Pannett, Coloplast Head of Market Access said, “Peristeen has been in the market for several years now and we are delighted that it has received a positive recommendation in NICE’s Medical Technologies Evaluation Programme (MTEP)." 

Dr Anton Emmanuel, Consultant Gastroentrologist at University College London Hospitals said, “Over the last ten years transanal irrigation has changed the treatment map for patients with bowel dysfunction (patients with constipation and faecal incontinence) whether due to neurological or functional conditions. The NICE appraisal is a critical update of the benefits and cost efficacy of Peristeen, and it will hopefully open up the treatment for those patients whose symptoms are not adequately relieved with current treatments.”

June Rogers MBE, Paediatric Continence Specialist at Bladder and Bowel UK said “This is good news for children and young people with continence problems, who are sometimes sadly forgotten by health services, as the focus often is on adult care.

It is important now to ensure that all paediatricians, GPs and nurses who work with children and young people are made aware of this promising therapy.

“Children with chronic constipation resulting in soiling, those born with anorectal malformations and those with a disability, or other problems resulting in no or poor bowel control have had limited treatment options until now. This new NICE guidance means that these young patients will now have another form of treatment available from the NHS. Hopefully this will also reduce the need for them to undergo surgery. It is important now to ensure that all paediatricians, GPs and nurses who work with children and young people are made aware of this promising therapy.”

Carol Adcock, a spinal cord injury Nurse Specialist with Spinal Injuries Association said “Effective bowel care is crucial in helping spinal cord injured people lead a fulfilled life. Transanal irrigation products like Peristeen are known to be both very effective and popular with spinal cord injured people as they reduce the severity of constipation and incontinence, improve quality of life and promote independence. We’re very happy that NICE has acknowledged the role that Peristeen plays in supporting good bowel function.”

Further information and support 

The NICE medical technology advisory committee acknowledged that Coloplast has a range of community-based and non-clinical services for Peristeen users and prescribers. These include a team of specialist nurses in the UK providing training and support for patients, combined with a telehealth programme that provides easily accessible patient support over the phone.

To download a copy of the NICE guidance, click here

For more information on the NICE MTEP programme, click here