Colorectal Program
Bowel Management Program
Our Bowel Management Program is a week-long outpatient program for children who have problems with bowel control. This may include constipation or fecal incontinence (soiling, stool accidents, encopresis). This issue may be related to children with:
- Anorectal malformations (imperforate anus, cloaca)
- Hirschprung's Disease
- Severe medically refractive constipation
- Spinal or sacral disorders that affect the bowel (spina bifida, spinal trauma, sacral coccygeal teratoma)
What Sets Us Apart
- You and your child will work closely with a medical team that may include a physician, nurse practitioner, registered nurse, dietitian, and child life specialist to find a daily bowel program that will empty the colon daily and precent soiling accidents.
- Each program is individualized to the child and may include changes to the diet, enemas, and/or medication.
Treatment Options
Laxative Program
A laxative is a medicine taken every day to help the patient have a bowel movement (poop). Our goal with a laxative is to have 1 - 2 bowel movements in the toilet daily and no accidents.Enema Program
An enema is a way to put fluid into the rectum and lower intestine to empty the stool. We use a catheter and fluid bag to administer the enema; you will learn how to do this at your clinic visit. Our goal with an enema program is to empty the colon with the enema and be stool and accident free between enemas.Appendicostomy (Malone, ACE, MACE)
An appendicostomy is another way to to give an enema which requires a surgical procedure. After an enema program is found to be effective, the physician may recommend an appendicostomy procedure to administer the enema solution through the appendix and large intestine. This will provide convenience and independence for children who require a large volume daily enema.Make an Appointment
- To make an appointment in the bowel management clinic, call (801) 662-1602.
- To schedule daily abdominal X-rays for "bowel boot camp," contact our nurse via email. Please note you need to visit us in clinic before you begin bowel boot camp.
- If you live outside of Utah, we may be able to connect with a hospital near you. If we cannot connect you to a local hospital, we can provide additional options.
What to Expect
Our clinic scheduler will work with you to set up the appropriate studies that are needed prior to your visit and your clinic appointment.
Studies & Tests (Medical Imaging)
Contrast Enema
- What it is: This is a test which uses X-rays and a special kind of enema solution to take pictures of the colon or large bowel (the lower part of the intestines). An enema is the injection of a liquid into the rectum through a small tube. The test shows the doctor is there are abnormalities of the colon or distal small intestine. This also works as a clean out for the large bowel, so we can start a new program with an empty colon. There is no special preparation for this test.
- Who needs one: All patients who will be starting a new bowel program, or as directed by the provider.
- Length of study: 30 - 45 minutes
KUB or Abdominal X-ray
- What it is: An abdominal X-ray or KUB study is a picture of the gastrointestinal system organs. It allows your provider to see the stool burden as well as the fluid from the contrast enema if it was not completely expelled.
- Who needs it: All patients coming for a bowel management program. We use this study for new patients as well as for patients coming in for a follow up appointment.
- Length of study: 5 minutes or less
Clinic Visit
Who will I see?
- Physician or nurse practitioner: You will see either a physician or nurse practitioner. They will review the tests, the patient history, do a physical examination, and determine a treatment plan.
- Registered nurse: Our nurse will be your main contact person. She will work with the providers on the treatment plan and provide education for you and your child.
- Child life specialist: Our child life specialist will help you children during the physical exam if needed and provide age appropriate suggestions for treatment. Learn More >
- Dietician: Our dietician will review growth of your child and provide dietary recommendations that coincide with our treatment plan.
How long will the appointment be?
Plan on at least 1 - 1.5 hours for the clinic appointment.What happens during the appointment?
- Our team will review the studies that were done and discuss the results with you to make a decision on a treatment plan.
- We will discuss your child's disorder and provide a physical examination to determine the best plan for your child.
- You will leave with an understanding of how continence works and a customized bowel program for your child.
Follow-Up
Your child will have a follow-up appointment in clinic 6 months following the initiation of a new bowel program and then yearly afterward. We can make adjustments to the program if needed during the follow-up visit, or over the phone between appointments if necessary.
Bowel Boot Camp
Boot Camp Process
You will start the bowel boot camp program the evening of your clinic appointment. Continue with your normal daily routine, including the following:
- Daily morning X-ray: More information below.
- Morning report: You will communicate with the clinic nurse, reporting on the last 24 - 48 hours of the treatment program.
- Colorectal team meeting: Our team will meet daily to review your report and the abdominal X-ray, and make any necessary small adjustments to the treatment program.
- Afternoon call: Our clinic nurse will call you with X-ray results and treatment changes as needed for the evening.
- End of the week: You will have a bowel management program that is customized to your child. You will continue with this new program until you next follow-up appointment.
Daily X-Rays
Part of bowel boot camp is one week of daily abdominal X-rays to monitor progress of the program.
Where to go?
You may get the X-ray imaging procedure done at one of the following options:
- An Intermountain imaging facility. This is the easiest and preferred option, as our team will be able to view the images immediately without any action on your part.
- A facility affiliated with Primary Children's. We have relationships with some facilities with the ability to share images with us via the internet. Please contact us to see if your local facility has a relationship with Primary Children's.
- A facility not affiliated with Primary Children's. If this is your only option, you can send your images to us via email once the procedure is complete. This requires you to ask for a copy of the image in a .JPG or .JPEG format. We will need to see the images the same day they are taken. Send the image as an attachment to us at PC-Colorectalclinical@imail.org.
Make an Appointment
Contact our nurse via email to arrange daily X-ray procedures. If you live outside of Utah, we may be able to connect with a hospital near you. If we cannot connect to a local hospital, we will provide alternative options.