I went to the Peristeen presentation today and here is what I came away with:
Essentially, there are two aspects of the Peristeen that make it more effective than a traditional enema. First, the water goes much higher into the colon and so there is a much more extensive clean out. The presenter showed x-rays from a constipated bowel, a bowel emptied by a cone enema, and a bowel emptied by the peristeen. The peristeen cleared out much more. Therefore, if you have a leaky bowel, the leakage is happening so high up in the colon that it doesn’t exit the body. Stool can not make it all the way down the colon is less than 24 hours so there shouldn’t be any accidents.
The second aspect is that there is a catheter (there are small and standard sizes) that you insert into the rectum and then you have a pump which you squeeze between 1 and 5 times depending on the tightness of the anal sphincter. The pump blows up a balloon which acts as an artificial sphincter–holding the water in. The cone enema is more volatile.
–Coloplast recommended using it once a day for the first month and then most people can use it every other day.
–they recommend waiting until the child is 3 yrs but have used it for a child as young as 2.
–there are centers all over the US who are trained to teach parents to use it–Cincinnati is the only? one that requires a week long stay. Generally, its an outpatient training.
–Coloplast said most likely you will continue to use medication–I know Cincinnati does not use senna–they add irritants to the water solution.
–It is covered by insurance and they are working on getting Medicaid to cover it–in some states it does, some it doesn’t
–the catheter is thrown away after use–because of the balloon and also because each is lubricated.
We have had success with the cone enema up to this point but we sometimes we will have “off” days so I can see this being a better solution for us before entering kindergarten.