Here you will find the recommendations we have made about the use of individual medicines in Lancashire.

Trans-Anal Irrigation Systems

Brand: Peristeen®, Qufora®, IryPump®,Aquaflush®
Indication: Neurogenic Bowel Dysfunction
Disease category: Gastro-intestinal system
Commissioning responsibility: CCG
PbR excluded: No


Treatment should be initiated and stabilised by specialist service providers for a period of 3 months. Prescribing responsibilities may then be transferred to primary care after the initial 3 month period only where there has been a demonstrable improvement in validated measures of bowel function such as the Cleveland Clinic constipation scoring system, St Mark’s faecal incontinence score or neurogenic bowel dysfunction score.

The Choice of product should be made by an appropriately trained specialist, in conjunction with the patient. Where possible the least invasive device, which meets the patients’ needs should be used in preference. It is recognised that there are differences in the levels of service provision across Lancashire and that use of TAI in non-neurogenic bowel dysfunction may result in a significant increase of use.

Existing primary care services cannot be expected to provide support for this. Therefore, TAI is only supported by the LMMG in the context of an agreed commissioning pathway. Specialist services are expected to retain responsibility for on-going patient follow-up and review (until such time that treatment is stopped).

Please see the link to the NICE technology guidance below. NICE advises the following:

A number of different transanal irrigation systems, including Peristeen, are available. Clinicians and patients should discuss the options available and may try a number of devices before settling on a preferred system…”


LMMG recommendation: Amber0
Click here to find the definitions for the colour classifications

Reason for decision:  Suitable for GP prescribing following recommendation/initiation by specialist

Supporting documents:

Trans-Anal Irrigation Devices Position Statement (version 1.2) (230.4 KiB)

Peristeen transanal irrigation system for managing bowel dysfunction (MTG36)

Decisions of Lancashire local decision making groups:

NHS Blackburn With Darwen CCG and NHS East Lancashire CCG NHS Blackpool CCG NHS Chorley and South Ribble CCG and NHS Greater Preston CCG NHS Fylde and Wyre CCG NHS Morecambe Bay CCG NHS West Lancashire CCG