AINTREE UNIVERSITY HOSPITAL, HEALTHY BOWEL CLINIC: FUNCTIONAL BOWEL DYSFUNCTION CARE PATHWAY This ‘Pathway’ is an example used in the NICE medical technology guidance adoption support resource for Peristeen. It was not produced for or commissioned by NICE Referral Triage Colorectal Outpatients Red Flags Healthy Bowel Assessment Patient Reported Outcome Measures Investigations as appropriate e.g. EAUS, ARP, DP, TMS Diet, Lifestyle & Medication  Clinical examinations: Ano-rectal/Vaginal/ Pelvic Floor Specialist treatment options as appropriate: e.g. Pelvic Floor Muscle Training, Biofeedback, Electrical Stimulation, Behavioural techniques, CBT, Defaecation Dynamics, PTNS.   Symptoms not managed Consultant Pelvic Floor Clinic Qufora Mini Rectal Irrigation System Consideration of Trans-anal Irrigation (TAI) Symptoms managed MDT discussion re: relevant factors e.g. H/O bowel surgery/radiotherapy If appropriate patient provided with Irrigation guidelines and information for peristeen or equivalent Discharge 1 hour Irrigation appointment : Informed written consent Rectal examination Demonstration and practise in clinic Review in 1 week Regular reviews until established on TAI Continuing annual reviews Patient given Clinic contact number and company information in case of difficulties