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A number of children suffer from various degrees of constipation or diarrhea. This can happen for many reasons. Some children have trouble with transient constipation when graduating from formula to solid foods. Other children may have specific structural disorders such as Hirschsprung's disease or anorectal malformations that leave them with long-term problems, including diarrhea, constipation or encopresis.
The goal of bowel management is to improve the quality of life for children by cleaning out the colon at regular intervals and then keep it quiet in the interim. For example, the goal would be for the child to have a bowel movement once a day and remain clean between bowel movements. Bowel management includes the use of enemas and, when indicated, diet manipulation and medications.
Children with repaired anorectal malformations (imperforate anus) make up the largest number of bowel management patients. However, the same techniques can be used to help children who suffer from constipation or encopresis due to other problems.
Bowel Management Week is an intensive six-day outpatient program in which parents and children learn the techniques necessary to be clean and continent. For the vast majority of patients, we can improve the function of the colon by "training" it to empty at a specific time. Bowel Management Week is held every month and is a six-day outpatient treatment.
You will attend a brief informational session about bowel management. From there, your child will undergo diagnostic studies that will be predetermined by the team. You will consult with a pediatric surgeon, and your child will be given an initial enema or laxative regimen. Typically, the first day is the longest day of the week. You can expect to spend approximately six hours at the hospital on the first day. The remaining visits are much shorter, requiring approximately two hours at the hospital.
You will be in contact with the nurse practitioner who coordinates the program. The pediatric nurse practitioner will let you know if any changes are needed and will be available for questions and concerns. Part of the treatment includes daily abdominal x-rays and consultation with the pediatric nurse practitioner. The pediatric nurse practitioner will review the x-ray with the pediatric surgeon and make the recommended changes, if any, to your child's program. On the final day of the week, an x-ray will be performed and you will consult with the pediatric surgeon one more time.
The multidisciplinary treatment team includes caregivers from a number of departments at Children's Hospital Colorado, including pediatric surgery, urology, gastrointestinal medicine, radiology, gynecology, neurosurgery, nursing, nutrition and social services.
The first step is for your child to see a pediatric surgeon at the International Center for Colorectal and Urogenital Care. At this visit, our team will determine if your child is a candidate for Bowel Management Week. Once it is determined that Bowel Management Week is the next step, a member of our team will contact you to help you prepare for the week.
For more information, please call 720-777-6571 or e-mail the care team.