Anal inserts may be used to manage faecal incontinence; the single use devices are inserted into the anal canal to prevent faecal leakage.

Before prescribing, a full medical assessment of the bowel condition should be carried out by specialist services (NHS bladder and bowel care team, or colorectal team), including an assessment of manual dexterity for inserting and removing the anal insert.

Consent must be obtained prior to undertaking assessments and treatment. This must be in line with national guidelines on consent and current local organisational policy. The outcome of assessment and rationale for treatment options must be documented in the patient records in accordance with national and local guidance on clinical record keeping. Be aware of abuse issues (multi-professional decision in respect of use in children), which could exclude the use in cognitively impaired patients.

Anal inserts are flatus permeable. They are available in two sizes. The smaller one should be used in the first instance and the larger one if leakage occurs around the smaller insert. Only one insert should be used at a time. Written information (available from manufacturer) should be provided to support the patient.

Anal inserts should be disposed of in household refuse and should not be flushed into the mains sewerage system.

Following specialist assessment, GPs may be asked to prescribe anal inserts; specific details of required products (and monthly quantities) will be provided to GPs by the specialist team. GPs should not make product and accessory changes without discussing with the NHS specialist team; any changes must be on specialist service recommendation only.

If a patient is ordering excessive quantities or reports difficulties please contact NHS Bladder and Bowel Care service for further advice:

• Exeter: 01392 208478
• Newton Abbot: 01626 324685
• South Molton: 01392 675336

Renew Insert (Renew Medical)

• Regular: FG730 (£71.12 = 30, £2.37 each)
• Large: FG731 (£71.12 = 30, £2.37 each)

Notes

1. Single use silicone plugs
2. Can remain in place until next bowel movement, however local specialists usually only recommend use for up to 12 hours
3. Removed by pulling the lower disc, or expelled with next bowel movement

Peristeen Anal Plug (Coloplast)

• Small: 1450
• Large: 1451

Notes

1. Single use foam plugs
2. Can be left in for up to 12 hours
3. Removed by pulling the soft gauze string attached to the plug