Tricks of the trade - transanal irrigation

Safety is always important and that includes insight on what may happen when you perform transanal irrigation (TAI). Bowel perforation is a severe but rare risk with TAI that is important to be aware of. Autonomic dysreflexia (AD) is a condition that may affect as many as 90% of spinal cord injured patients with injuries at or above the 6th thoracic vertebrae. Users could also experience bleeding, challenges with the rectal balloon and leakage. A specialist in the following films shares his tricks for a successful outcome of TAI.

Potential complications

Practical tips

To achieve a successful procedure, it is important to have the right water temperature (should be about body temperature) and there are aids that could be useful such as padded toilet sits.

Rectal catheter balloons

There are some tricks on how to avoid balloon bursts or catheter expulsions that may occur due to rectal spasms.

Minor complications

Hemorrhoids are common in patients with neurogenic bowel and constipation and are a common reason for the bleeding.


An issue users may experience is leakage of water after irrigation.

Autonomic dysreflexia

AD is an episodic uncontrolled elevation of systolic blood pressure that is caused by a noxious stimulus below the level of injury. A noxious stimulus can be a distended bladder or constipation and it is therefore important to have good bladder and bowel management in place.