1. 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