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Bowel Management is a program developed for children who have problems with bowel control. This may include constipation or soiling (also called fecal incontinence). The goal of a bowel management program is to clean the colon of stool (poop) and prevent accidents. An effective bowel management program will improve your child’s quality of life and function.
Bowel Management Week
The bowel management program is an outpatient program implemented over a one-week period in which we teach parents and children how to empty the colon daily in order to be free of accidents.
The week will begin with diagnostic studies pre-determined by the multidisciplinary team. You will meet with a pediatric surgeon and pediatric nurse practitioner (PNP) to determine the appropriate treatment plan. This plan may include enemas or laxatives.
Daily abdominal x-rays are obtained to visualize the effectiveness of the treatment. The pediatric surgeon and the PNP review the x-rays daily. You will be in contact with the PNP daily to report your child's response to the treatment and be advised of changes that need to be made to the treatment. You will also have the opportunity to ask questions or express concerns you may have about the program.
At the end of the week we should have a program that effectively empties the colon and keeps your child accident-free.
Enemas provide an artificial way to empty the colon daily and prevent accidents. We will teach you how to administer enemas at your child's clinic appointment and give you the necessary supplies to get started.
Laxatives may be recommended to manage constipation. There are many different types of laxatives. We will work to find a laxative and dose that works for you child.
Abdominal X-rays may be done at any facility:
- Intermountain Facility- this is the easiest, we are able to view the images immediately.
- A facility connected to Primary Children's. We have a relationship with some facilities with the ability to share images over the internet. Please contact the PNP to see if your local facility has a relationship with Primary Children's.
- Send your images via email. We will need to see the images the same day they are done.
- This requires you to ask for a copy of the image on a disc in a .JPG or .JPEG format.
- Send the image as an attachment in an email to sarah.zobell@imail.org
You may need to purchase additional items for the bowel management program. Here is additional information on these items:
Appendicostomy (or Cecostomy)
Some children may require long-term enemas as part of their bowel management. An appendicostomy (or Malone procedure, sometimes called a MACE or ACE) is an option once we have established an enema program that is effective in cleaning the colon daily and keeping your child free of accidents. With an appendicostomy the daily enema will be given through an opening on your child’s belly, providing privacy and independence for your child.