Rectal irrigation is an effective conservative treatment for bowel dysfunction, yet patients often face stigma and uncertainty regarding its use. TikTok has emerged as one of the fastest-growing platforms globally. TikTok offers short-form video content that facilitates rapid, peer-driven health communication. This format can enhance awareness, education, and adherence by presenting relatable experiences in an accessible and engaging manner. This study analyses TikTok content on rectal irrigation to understand patient experiences, priorities, and informational gaps faced by users.

Hashtags associated with rectal irrigation were searched, and the first 100 videos per hashtag were screened by two independent reviewers. Patient videos on rectal irrigation created by unique users were included. Videos not in English were excluded. For users who posted multiple videos on rectal irrigation, only the first video was included in the analysis. Data were extracted on creator demographics, engagement metrics, device type, and content characteristics. Thematic analysis was then conducted to identify recurring patterns and themes.

Across six unique hashtags, a total of 1079 videos were identified, of which 123 met the eligibility criteria. Videos from 21 unique creators met the inclusion criteria (Figure 1). All creators were patients using rectal irrigation themselves, with no videos created by clinicians or healthcare companies. Over half of creators (58%) posted multiple irrigation-related videos, and 90% of the included videos featured high-volume irrigation systems. Videos had a mean duration of 152 seconds and generated substantial engagement, averaging 2,592 likes, 81.8 shares, and 39 comments. 

Three overarching themes emerged (Table 1). Practical instruction and device navigation dominated, with creators demonstrating equipment (95.2%), describing irrigation steps (61.9%), and referencing manufacturers (90.5%). Clinical purpose and perceived effectiveness captured users’ explanations for adopting irrigation (81.0%) and their reports of symptom improvement (33.3%). Psychosocial and quality of life narratives reflected efforts to break taboos, normalise irrigation (38.1%), narrating impact of irrigation on quality of life (33.3%), and offer reassurance or support to viewers (28.6%).

The high engagement metrics, particularly in likes and shares, suggest that this content resonates widely and viewers are actively distributing this content within their networks, amplifying peer-to-peer normalisation far beyond the original audience. This can create a foundation for more open dialogue between patients, and consequently between patients and their clinicians. 

These thematic analyses reflect a patient-driven digital landscape in which individuals using rectal irrigation have self-organised to share practical knowledge and lived experience. The dominance of practical instruction and device demonstration suggests that patients primarily turn to TikTok to fill educational gaps left by formal healthcare encounters, particularly around the mechanics of irrigation and day-to-day device use.

TikTok content on rectal irrigation primarily focuses on practical guidance and the normalisation of the practice, with users sharing personal motivations and perceived benefits. However, troubleshooting, device comparisons, and help seeking are notably limited. Patients navigating the complexities of rectal irrigation, therefore, encounter limited evidence-based guidance. This highlights the importance of clinicians providing clearer, evidence-based digital education to better support patients. This can be further enhanced by engaging healthcare professionals to work with patients in these digital spaces.