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Fecal impaction is a common result of neurogenic bowel dysfunction and causes immense discomfort and pain. Its treatment includes laxatives , enemas , and pulsed irrigation evacuation (PIE) as well as digital removal.
MACE, Malone procedure, ACE procedure, continent appendicostomy, Malone antegrade colonic enema [ edit on Wikidata ] A Malone antegrade continence enema (MACE), also known as an appendicostomy or Malone procedure, is a surgical procedure used to create a continent pathway proximal to the anus that facilitates fecal evacuation using enemas .
Bowel management is the process which a person with a bowel disability uses to manage fecal incontinence or constipation. [1] People who have a medical condition which impairs control of their defecation use bowel management techniques to choose a predictable time and place to evacuate. [1]
As bowel stimulants, enemas are employed for the same purposes as orally administered laxatives: to relieve constipation; to treat fecal impaction; to empty the colon prior to a medical procedure such as a colonoscopy. When oral laxatives are not indicated or are not sufficiently effective, enemas may be a sensible and necessary measure. [9]
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This may occur when there is a large mass of feces in the rectum (fecal loading), which may become hardened (fecal impaction). Liquid stool elements can pass around the obstruction, leading to incontinence. Megarectum (enlarged rectal volume) and rectal hyposensitivity are associated with overflow incontinence.
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Transanal irrigation uses a large volume water enema system. [2] It is carried out every day (or every 2 days) by the patient or carer as a long term management for bowel dysfunction, including fecal incontinence and/or constipation (especially obstructed defecation ).