Children's Hospital Colorado

Living with Cloaca

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Contact our Center for Colorectal and Urogenital Care


Looking ahead

Anorectal malformations like cloaca require lifelong management. Our families have many questions and worries about what life will be like for their daughters as they grow up. Will school life will be normal for them? When their daughters become adults, will they be able to have children?

Our families discuss living with cloaca

With the right treatment and support, children with cloaca can lead healthy, productive lives. After meeting and hearing Linda's story, an adult with cloaca who now has a child of her own, they feel reassured.

Living with cloaca

Bowel control is a challenge for some patients with cloaca. They may need to start a bowel management program at about 3 years of age. They may also need long-term enema therapy if they need enemas for life.

Bowel management

At about 3 years old, when most children get out of diapers, our colorectal team helps patients with cloaca start a bowel management program. The goal is for a child to have a bowel movement once a day and remain clean between bowel movements.

Learn about our Bowel Management Program

Long-term enema therapy

If a child needs enemas for life, they may be able to have an antegrade continence enema (ACE) procedure, also called the Malone procedure, when they are 5 to 8 years old.

Learn about the ACE procedure

Gynecologic and reproductive health

Girls born with cloaca have unique gynecologic needs and concerns from puberty through adulthood. Our team is there to learn about your daughter's condition, establish trust and provide the ongoing care she'll need.

Hope for the future

Sandy and Gabriela worry about their daughters' ability to have children when they become adults. Although there is no guarantee that Tashi or Allison can have children, Linda reassures them that their daughters can lead a normal life. And, maybe one day they, too, can have children of their own.

Tips for living with cloaca

  • Try different supplies to find which ones work best for your child.

    Before your child has colostomy surgery, call colostomy suppliers to ask for samples so they will be ready when you need them.

  • Get support.

    Join a colostomy support group to learn and get support from other parents.

  • Ask about bowel management.

    Ask the doctor about starting bowel management when your child is around the same age that other children begin potty training.

  • Be prepared for travel needs.

    When you travel by airplane, pack medical supplies in a separate bag to carry with you in case there is a delay in the airport or your baggage gets lost.

  • Carry extra clothes for your child.

    Always carry extra clothes for your child when you are away from home. Send extra clothes with your child to school in case your child has an accident.

  • Find a gynecologist for your daughter.

    Have your daughter establish a relationship with a gynecologist early in life, and schedule a gynecologist follow-up at early signs of puberty.

Download these tips for living with cloaca

Dr. Bischoff hugs Sandy
"We honestly consider it a privilege to be able to be part of your journeys, to be able to have your trust, in ourselves, in our hands."
Dr. Andrea Bischoff

Additional patient resources

Partnership with the University of Colorado School of Medicine

Children's Hospital Colorado partners with the University of Colorado School of Medicine, where many of our physicians and care providers serve as faculty.