Faecal collectors are a group of devices which includes anal pouches, rectal tubes & catheters, and rectal trumpets.
There are several categories of faecal collector available:
External anal pouch This consists of a bendable wafer which has an opening at its centre. One side of the wafer adheres to the skin around the anus and the other side is connected to a collection bag.
The bag has a re-sealable port at the bottom end through which faeces can be emptied without the need to remove the wafer from the skin. This port can also be connected to a larger gravity drainage bag. Some bags also have a flap to allow flatus to escape and prevent the bag filling with gas.
Intra anal stool bag This is made of latex (20cm non extended, 26cm extended) that is inserted into the anus and an adhesive attachment (10cm in diameter) applied round the anus 1 to secure it in position.
Rectal tubes and catheters These are inserted into the rectum to channel loose stool into a collection bag. A balloon near the tip of the catheter (inside the body) can be inflated once the catheter is in position to prevent leakage of stool around the catheter and to prevent the tube from coming out during a bowel movement 2
Rectal trumpets The trumpet is made up of a naso-pharyngeal airway connected to a drainage bag. The flange (wide) end of the trumpet is inserted into the rectum.3 A trumpet is shorter than a rectal tube so there is less chance of damaging the lining of the rectum. The other narrow end of the trumpet can be connected to a drainage bag.
These devices channel stool from the rectum and collect it in a container which is periodically emptied. They are usually only suitable for loose stool. (Bristol stool chart grade 6/7)1
They are used mainly by people who are very ill or confined to bed and need help with bowel management 24567
Stool is either drained from the rectum before leakage occurs through insertion of a tube, or is collected as it leaves the body. A container is either attached to the drainage tube or sticks to the skin around the anus (peri-anal area).
Faecal collectors do not stop bowel leakage but help to prevent leaked stool coming into contact with the skin and causing skin damage. In this way they can also allow damaged skin to be treated.
They may also reduce the amount of soiled linen and bed changes required. 8
External anal pouch
Putting these pouches on can be tricky especially for people who have a small space or severe oedema between the anus and vagina or scrotum.
It can be difficult to maintain the seal round the anus, especially if the skin in the area is already damaged and pouches are not recommended for use if the skin is very sore 36
However, unlike other faecal devices, the anal pouch can collect leaked stool of any consistency without clogging if it is used without the additional drainage bag.
Research evidence has shown that successful use of a pouch can assist with healing of pressure ulcers. 9
Rectal trumpets offer an alternative to the rectal pouch when adherence to the skin is a problem and may help to keep skin healthy or promote healing by reducing the risk of stool in contact with the skin. 410
There is a risk of the trumpet inadvertently coming out with straining or coughing, or being pulled out with linen changes or accidental pulling on the collection bag. 3
Rectal tubes and catheters
These devices work best with very liquid stool which is most likely to flow without blocking the drainage hole. 711 They are often used in conjunction with bowel management programmes including daily saline irrigations through the rectal catheter to keep the stool liquid.
It has been suggested that cutting the tip of the catheter off at an angle helps drain stool of a slightly thicker consistency. 12
They are useful to promote healing of damaged skin round the anus by limiting further contact between stool and skin, and are most suitable for people confined to bed.
External and internal anal pouches can cause skin damage from the effect of the adhesive on skin.
Rectal catheter systems are only suitable for use with liquid stool and the tape used to secure rectal catheters can cause skin damage. 413
Use of a rectal tube (or trumpet) with or without inflating the balloon is controversial because of the risk of damaging the lining of the rectum or anal sphincter, or stimulating intestinal secretions, making diarrhoea and bowel leakage worse 111214
There have been reports of more serious complications from use of rectal catheters including rectal bleeding (on occasions requiring blood transfusion), mucosal pressure necrosis, fistula and autonomic dysreflexia. 151617
Because of these risks it is recommended that these products are only used under the supervision of a health care professional experienced in their use
There is always the possibility of leakage from the product onto clothes or furniture.
They are only suitable for people confined to bed.
These devices are designed to be used by health care professionals or a caregiver that has received training.
Correct insertion/application is very important to give the best chance for all these devices to work and to minimise any risks associated with their use.
Any liquid or solid stool should be flushed down the toilet.
The device may they be wrapped in nappy sacks or scented bags and disposed of in the normal household waste. Alternatively put them in clinical waste bags if available.
Click on Worldwide to go to organisations where you live for local information about disposal.
The cost of these devices varies according to which country you live in, so it is not possible to give an exact price range.
They can be purchased directly from the manufacturer by phone or on the internet. Look at the suppliers list
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