Can Colon Irrigation Help You Win the Brawl with the Bowl?

When laxatives fail, colon irrigation with the HyGIeaCare system just might be the answer, a new study suggests.

Japanese children's author Tarō Gomi was right, "Everyone Poops." Unfortunately, that particular bodily function is easier said than done sometimes.

"Constipation can have a dramatic impact on the patient's overall well-being, including anxiety, depression, and time lost off work," Gavriel Meron, chairman and CEO of HyGIeaCare Inc., told MD+DI.

Constipation about 60 million people in the United States alone, Meron said, which is why there is no shortage of over-the-counter constipation products on pharmacy shelves. But for a lot of people, Meron said, those products simply don't help. "And their life, it's really not a life because they take very, very strong laxatives and the thing with the laxatives is they don't work, they don't work, and then all of a sudden they have an explosive event and it's an urgent explosive event," Meron said. "What happens is when they start taking these strong laxatives they don't want to go out. They don't want to go to a wedding, they don't want to go to a movie, they don't want to go to a restaurant because they're waiting and wondering 'when is this explosion going to happen'?"

A study recently published in the Journal of Clinical Gastroenterology and Hepatology suggests the HyGleaCare colon irrigation system could be a good solution for chronically constipated patients.

Meron was the founding CEO of Given Imaging, the company that developed the PillCam, which Covidien bought for $860 million before its merger with Medtronic. He founded HyGleaCare in 2015 as a way to leverage his experience in GI and to develop a better way to prep patients for colonoscopy.

The FDA-cleared HyGIeaCare Prep replaces conventional preps, which typically include a lot of laxatives and/or enemas the night before the procedure. The company currently has four U.S. centers that provide HyGleaCare as a service that can be done on the same day as a patient's scheduled colonoscopy, with additional centers in the works. The system works by placing a sterile, disposable nozzle in the patient's rectum, and infusing it with a stream of warm water, loosening the stool and allowing the patient to evacuate their colon right there on the basin in a private room, under the supervision of a technician.

"The study came because we had numerous physicians who started referring us patients who are constipated," Meron said.

The study enrolled 175 patients who were consecutively referred (not pre-selected) to the company's centers for constipation relief, and 100% of these patients achieved a bowel movement and relief from their constipation, and there were no adverse side effects, Meron said.

The primary endpoint of the study was the successful passage of stool during the colonic irrigation with secondary endpoints being patient satisfaction and a favorable side effect profile. Meron said the centers are already seeing repeat visits from patients who suffer from chronic constipation.

"In one of our centers a patient was referred to the emergency room because of severe constipation and blockage, and at the emergency room they decided to refer the patient to the nearby HyGIeaCare Center for relief, which was successfully achieved."

It's possible that the system has another benefit for chronic constipation patients beyond the immediate relief of unclogging the pipes, so to speak, because it may theoretically alter the microbiome with the hopes of repopulating a more favorable microbial profile.