Bowel Management Program

Children who benefit from the Bowel Management Program experience problems with constipation or incontinence for a variety of reasons and may have other medical conditions such as:

• Previously repaired anorectal malformations and cloacal malformations
• Previously repaired Hirschsprung disease
• Motility disorder and severe and chronic constipation (encopresis)
• Spinal disorders that affect the bowel (spina bifida, myelomeningocele, absent sacrum, sacrococcygeal teratoma)

Our program uses a multidisciplinary approach to treatment, with access to all of the pediatric colorectal specialists needed to oversee your child’s care in one place. The program addresses all of the behavioral and/or medical issues that are contributing to a child’s problems with fecal incontinence.

How the Bowel Management Program Works

Children are seen on an outpatient basis for an intensive week of therapy, and then at about 3 and 12 months. Enemas or laxatives may be given to ensure your child has a clean bowel before treatment begins. Your child’s treatment is specifically tailored to their unique needs and condition. Medical specialists work closely with other clinicians in the field, including nurse practitioners with specialized training in colorectal disorders, child psychologists, social workers and nutritionists to customize treatment plans and make adjustments when necessary.

Treatment at our bowel management clinics include:

• Administering medications (such as laxatives) or enemas when needed to soften stool and relax rectal muscles.
• Customized nutrition plans developed by dietitians who create kid-friendly recipes that are high in fiber and offer helpful tips for parents who may have a picky eater. The chosen diet may need to either promote or slow down stooling.
• Education for families on how continence works and why some children experience soiling
• Establishing a bathroom schedule and routine (based around the gastrocolic reflux) to train your child to recognize their body cues and to avoid soiling and accidents
• Connecting with parent support groups
• Setting up a reward system to help encourage your child to go to the bathroom
• Social work helps provide assistance in making travel arrangements and accommodations for those visiting from out of state.

Your child’s time in the program may vary depending on several factors including their age, the type of surgical procedure they’ve had (if any) and the severity of their condition. Typically, children who are at potty training age see positive results within three to four months. School-age children may see results anywhere from six months to a year. The success of the program depends largely on following the protocols put into place and working closely with your child’s healthcare team. We make sure we are there for you and your child through every step of their treatment. Our team connects with patients one month, three months and one year after completion of the program. Together, we can help your child achieve success and become accident-free.