Anton V Emmanuel

Transanal irrigation is a well-established minimally invasive therapy that addresses symptoms of both constipation and incontinence. The therapy has been extended from just neurogenic bowel dysfunction patients to those with disorders of brain–gut interaction and postsurgical conditions. To summarized the literature on transanal irrigation and update the contraindication profile. Initiation of therapy as part of a bowel care regime is becoming more common outside specialist centers.

Depression is a leading cause of disability worldwide, and improving its treatment is a global health priority.1 A third of patients do not achieve remission with current treatment approaches, which has a significant effect on occupational and social functioning.Reference Rush, Warden, Wisniewski, Fava, Trivedi and Gaynes2 First-line antidepressants also have limited efficacy in treating some symptom clusters, such as cognitive impairment.Reference Shilyansky, Williams, Gyurak, Harris,...

Partha Kar, consultant in diabetes and endocrinology1, Anton Emmanuel, professor of neuro-gastroenterology and lead for workforce equality2 1Portsmouth Hospitals NHS Trust 2Welsh Government Follow Partha Kar on X @parthaskar There’s been a spate of recent tribunals and cases from NHS staff on the grounds of workplace discrimination.