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.
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.