Template Letter for GP re Rectal Interventions

Use this template letter to recommend that the child's GP prescribes a rectal intervention.

GP Name

Name and address of surgery

Clinic address


Dear Doctor ____________________________,



[Child’s name] was recently seen [at home/at school/in clinic]. I have reviewed [his/her] constipation management. Despite optimal use of laxatives and diligent adherence to a regular, effective toileting programme [child’s name’s] bowel emptying problems persist.

I have explained that a range of rectal interventions exists, and that ideally the child commences a simple intervention, advancing through the more complex options as required until the optimum treatment is identified. The aim is for [child’s name] to evacuate [his/her] bowel effectively and regularly and to prevent faecal soiling.

The intervention is commenced on a daily basis, at a similar time every day. The escalating schedule is as follows:

  • LecicarbonC or Bisacodyl Suppository, or Sodium Citrate Micro-Enema
  • Mini rectal washout such as Qufora Mini or Aquaflush Compact
  • Simple rectal washout such as Aquaflush Actif or Qufora Cone System or Dansac
  • More complex bowel washout such as Peristeen or Navina or Qufora Balloon System or IryPump

The subsequent options would be surgical, either an incontinent or a continent stoma.

Prescribing information can be accessed via the ERIC website www.eric.org.uk – look for Links to Bowel Equipment Product Information.

I have explained the range of options to [child’s name] and I have given the family the ERIC leaflet ERIC’s Guide for Children living with Complex Bladder and Bowel Problems. I have suggested that the parents make an appointment to see you to discuss a prescription; the product they would like to try first is ____________________________________.

I will provide the family with teaching and support in using the products and monitor [child’s name’s] progress.

Please let me know if you require any further information. You can contact me on___________ / at _________________.


Many thanks.

Yours sincerely,



Health professional’s name
Health professional’s designation

Upcoming dates

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