Consensus on Safe Initiation and Monitoring of Transanal Irrigation to Optimize Adherence With Therapy
Bibliographic record
Abstract
BACKGROUND: Transanal irrigation is a well-established minimally invasive therapy that addresses symptoms of both constipation and incontinence. The therapy has been extended from just neurogenic bowel dysfunction patients to those with disorders of brain-gut interaction and postsurgical conditions. AIM: To summarized the literature on transanal irrigation and update the contraindication profile. MATERIALS AND METHODS: We undertook a literature review of transanal irrigation complications and outcomes. RESULTS: Initiation of therapy as part of a bowel care regime is becoming more common outside specialist centers. In addition, the concept of both high- and low-volume irrigation schedules has entered the treatment paradigm, and it is clear that there is a differing safety profile. We present an update from the previous long list of contraindications. DISCUSSION: We describe how optimizing long-term adherence depends on these factors in addition to a structured follow-up programme. CONCLUSION: Transanal irrigation is an increasingly used therapy, with a good safety profile, further improved by the advent of low-volume irrigation options. Key to safe and effective usage of transanal irrigation is careful patient selection allied to tailored initial training of the patient.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".