How Can Chronic Constipation Be Treated?

Understanding Transanal Irrigation (TAI) and Colon Hydrotherapy (CHT): New Options for Gut Health

Chronic constipation is a common health concern that can significantly affect quality of life. When lifestyle changes or laxatives begin to lose effectiveness, medicine has developed and introduced new treatment options, including Transanal Irrigation (TAI) and Colon Hydrotherapy (CHT). These techniques are gaining attention in the field of integrative medicine.

Understanding the Causes of Chronic Constipation

Chronic constipation is complex and does not always arise from a single cause. Medically, it can be divided into three main groups:

• Normal Transit Constipation: This is the most common type, found in more than 50% of patients. It is often associated with abdominal pain, bloating, and symptoms similar to constipation-predominant irritable bowel syndrome (IBS-C).
• Slow Transit Constipation: Stool remains in the colon for too long, causing excessive water absorption. As a result, the stool becomes hard and difficult to pass.
• Defecatory Disorders: These occur due to structural problems or dysfunction in the muscles involved in bowel movement, such as pelvic floor dyssynergia, which makes it difficult to evacuate stool properly.

In addition, stress and frequently holding in bowel movements due to daily lifestyle habits are also important factors that can disrupt bowel function.

What Is Transanal Irrigation (TAI)?

Transanal Irrigation, or TAI, is a procedure that patients can perform at home using a specially designed device. It introduces water, averaging around 700 millilitres, into the rectum to cleanse the lower bowel more thoroughly than a standard enema.

Benefits of TAI

• Helps relieve and prevent constipation effectively
• Reduces problems related to faecal incontinence
• May help rebalance the gut microbiota and improve quality of life

Precaution: TAI is not suitable for patients with bowel stenosis, colon cancer, active inflammatory bowel disease, or pregnant women.

Colon Hydrotherapy (CHT): Deep Colon Detoxification

Colon Hydrotherapy, or CHT, is often known as colon detoxification. It is considered a more advanced technique than TAI, using equipment that can control water volume and pressure, with water flow ranging from 0 to 2 litres per minute.

This process must be performed using sterile equipment, with water temperature controlled at around 37°C. A specialist may also perform abdominal massage during the procedure to help the fluid cleanse the colon more thoroughly.

Benefits of CHT

• Stimulates bowel movement and helps relieve constipation and bloating
• Helps cleanse the bowel and reduce discomfort in the digestive tract
• May support the balance of the gut microbiome

Precaution: CHT should only be performed by a qualified professional to reduce the risk associated with water pressure that may affect the intestines.

The Gut-Brain Axis: A Remarkable Connection

The gut is often described as the “second brain” of the human body. The gut and brain constantly communicate through what is known as the Gut-Brain Axis. The gut is also a major source of important neurotransmitters, including serotonin, with around 90–95% produced in the gut, which plays a role in mood and happiness.

From the perspective of bio-integrated medicine and the PNEI model, the gut is also connected to three forms of the body’s “memory”: metabolic memory, immune memory, and epigenetic memory. Therefore, combining Colon Hydrotherapy with psychotherapy may help reduce stress, release psychological blockages, and support the release of deeper emotional tension that has accumulated over time.

Conclusion

Transanal Irrigation (TAI) and Colon Hydrotherapy (CHT) are promising options for chronic constipation that does not respond well to conventional treatment. However, the decision to undergo either procedure should be based on the patient’s symptoms and should always be guided closely by a doctor or qualified specialist.

Reference

Borghini, R., Borghini, F., Spagnuolo, A., Borghini, A., & Borghini, G. (2026). Usefulness of Transanal Irrigation and Colon Hydrotherapy in the Treatment of Chronic Constipation and Beyond: A Review with New Perspectives for Bio-Integrated Medicine. Gastrointestinal Disorders, 8(1), 6. https://doi.org/10.3390/gidisord8010006