For healthcare professionals
A non-invasive, device-based option in bowel management
Intermittent Colonic Exoperistalsis (ICE) is a non-invasive, device-based approach designed to support bowel movement through external mechanical stimulation.
The MOWOOT system delivers ICE in a standardized and reproducible way, allowing it to be considered within structured bowel management pathways
Physiological support through external stimulation
Under normal conditions, coordinated colonic contractions facilitate intestinal transit. When peristalsis is reduced or disordered, stool progression may become impaired.
ICE applies gentle, sequential external pressure along the anatomical course of the colon. The approach is designed to reflect physiological movement patterns and support intestinal transit without entering the body or forcing evacuation.
Beyond mechanically mobilizing colonic contents, externally applied pressure may engage colonic mechanosensory pathways. The large intestine contains mechanosensitive cells involved in enteroendocrine and neurotransmitter signaling, including pathways linked to serotonin, which plays an important role in colonic motility, secretion, and gut-brain communication (Mercado‑Perez et al., 2022). Although a direct interaction has not been fully demonstrated, these well‑established pathways provide a plausible additional physiological basis for the broader clinical effects observed with Intermittent Colonic Exoperistalsis, beyond a purely passive mechanical action.
Positioning within care pathways
ICE may be considered as a non-invasive option within bowel management when conservative measures alone are insufficient, or when a non-invasive approach is clinically appropriate.
ICE can be integrated into an overall bowel management plan and does not preclude the use of other interventions if additional support becomes necessary.
Patient selection and expectation setting
Successful use of ICE depends on appropriate patient selection, clear expectation setting, and adherence to key practical guidance.
Key criteria include:
Chronic constipation
Patients with chronic or refractory constipation
Daily use
Ability and willingness to engage in regular daily treatment sessions
Gradual response
Understanding that treatment effects develop progressively over time
For full details on indications, contraindications, and precautions, please refer to the Instructions for Use (IFU).
Standardized delivery without procedural burden
ICE with the MOWOOT system is delivered externally and does not require rectal access or internal administration.
The system is designed for regular home use following appropriate patient instruction, supporting independence while maintaining controlled and reproducible treatment delivery.
Key points to communicate to patients
Appropriate patient instruction and expectation setting are important determinants of treatment success with ICE.
When introducing MOWOOT, clinicians should emphasize the following points:
Correct belt size selection
Selecting the appropriate belt size is essential to ensure correct positioning, effective pressure transmission, and patient comfort.
Accurate belt positioning and fit
The belt should be positioned between the lowest rib and the hip bone, with the coloured seam centred over the abdomen (aligned above the navel). A snug fit – tightest while still comfortable – supports consistent and reliable delivery of ICE.
Early signs to notice
ICE is intended for daily use. Encouraging patients to perform sessions at approximately the same time each day supports the development of a predictable bowel management routine and consistent outcomes.
Consistency is key
Treatment sessions should be performed in a relaxed, laid-back or supine position. Relaxation of the abdominal musculature reduces counter-pressure and supports effective delivery of the sequential external stimulation.
Clear communication of these practical points helps support adherence and reduces variability in treatment response.
Clinical evidence
ICE with MOWOOT has been evaluated in multiple clinical studies and real-world use settings, reporting:
Improvements in bowel symptoms
Improvements in quality-of-life measures
Sustained adherence with daily use
Results may vary between individuals.
Tools and materials for clinical practice
Healthcare professionals have access to dedicated resources, including:
Clinical overviews and mechanism summaries
Patient selection guidance
Patient education materials
Training and support resources
These tools are designed to support informed clinical decision-making and effective patient communication.
Information on availability, access routes, and distribution can be found in the Access section.
Reference: Mercado-Perez A, Beyder A. Gut feelings: mechanosensing in the gastrointestinal tract. Nat Rev Gastroenterol Hepatol. 2022 May;19(5):283-296.