eP624 - Initial Evaluation of the Utility of Peristeen in Colorectal Clinical Practice

Purpose/Background: The debilitating symptoms associated with constipation, postoperative bowel irregularity, and fecal incontinence can have a significant impact on a patient’s quality of life. When conservative measures fail, patients may ultimately require a colectomy or ostomy. The Peristeen transanal irrigation system offers a valuable therapeutic alternative in patients with bowel dysfunction, however, there are few studies investigating its use in adults. This study aims to evaluate the efficacy of Peristeen in a single center in adults with bowel dysfunction.Methods/Interventions: This was a prospective study of patients referred to the Johns Hopkins Bowel Control Center who were initiated on Peristeen transanal irrigation treatment between January 2017 and May 2023. We administered the validated neurogenic bowel dysfunction (NBD) score to assess bowel function before and at a minimum of 3 months following Peristeen training via phone survey. The primary outcome was avoidance of ostomy/colectomy. Secondary outcomes included overall NBD score (higher NBD scores represent greater severity of symptoms), general satisfaction scores (higher score represents greater satisfaction with symptoms), duration of Peristeen use and reasons for discontinuation. Overall and individual symptom scores were compared before and after Peristeen initiation using Wilcoxon signed rank test. A subgroup analysis stratified by the aetiological group was performed.Results/Outcomes: A total of 137 patients have been trained on Peristeen at our institution and 40 patients were initially examined. The pre-peristeen NBD questionnaire was completed by 30 patients. Median age was 45.5 years (IQR; 33.5, 59) and 67.5% of patients were females. Dysmotility/functional bowel disorders was the most common etiology for peristeen use representing 62.5% (n=25) of patients. The median time of Peristeen use was 16.5 months (IQR; 5.5, 30) and median follow-up was 33.5 months (IQR; 22.74, 54.05). Thirty-four patients (85%) were colectomy/ostomy-free at time of follow-up; 5 patients (12.5%) underwent surgery (4 ostomy, 1 colectomy). Compared with baseline, there was significant overall improvement in total NBD scores (mean [SD] score 14.97 [7.72] at baseline vs 8.3 [6.74] at follow-up; P < 0.001) and general satisfaction scores (mean [SD] score 2.25 [1.94] at baseline vs 6.6 [2.39] at follow-up; P < 0.001). Patients experienced the most improvement in the frequency of bowel movement (BM), symptoms after BM, and less need of tablets for constipation. More than half of the patients (57.50%) were still adherent to Peristeen past the 1-year mark. Main reasons for discontinuation were lack of efficacy (62.50%) and technical factors (25%). In the subgroup analysis, 8 of 9 patients (88.89%) with neurogenic bowel were still adherent to Peristeen use past the 1-year mark and had improvement in their total NBD scores (mean [SD] score 18.88 [7.24] at baseline vs 11.44 [8.42] at follow-up; P=0.008). In patients with dysmotility/functional disorders, 10 patients (40%) were still adherent to Peristeen past the 1-year mark with overall improvement in NBD scores (mean [SD] score 12.11 [7.54] at baseline vs 6.48 [5.59] at follow-up; P=0.019).Conclusion/

Discussion: The Peristeen transanal irrigation system provides a safe and effective alternative therapy for patients with bowel dysfunction and its use can potentially help certain patients avoid ostomy/colectomy and improve quality of life. Further long-term studies evaluating the use of Peristeen in the adult population are needed."Outcomes For Patients Before and After Peristeen Initiation

Neurogenic bowel dysfunction scores: higher scores represent greater severity of symptoms. General satisfaction scores: higher scores represents greater satisfaction with symptoms.
Outcomes For All Patients Using Peristeen
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