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At the Colorectal Center, our
team provides comprehensive care for children with fecal incontinence. Because
fecal incontinence can be accompanied by other conditions, such as urinary
incontinence, we work closely with other specialists throughout the medical
center to ensure that our patients’ complex needs are met.
For many patients, treatment
involves following a balanced diet that our registered dietitian develops for
them based on their specific needs. Other treatment methods can include taking recommended
medications and participating in our Bowel Management Program.
percentage of patients with fecal incontinence may need surgery to remove part
of the colon, correct an anatomic abnormality or create an alternative way of
delivering enemas (Malone appendicostomy). And some patients benefit from
sacral nerve stimulation, a novel treatment that involves implanting a device
that delivers mild electrical pulses to the pelvic nerves. The Colorectal
Center is one of only a few pediatric institutions in the world that offers
sacral nerve stimulation to help children with fecal incontinence achieve bowel
Management and treatment involves distinguishing between true and pseudo incontinence, and then determining the proper protocol of treatment. Treatment of incontinence should be regarded as “care” aimed at raising a child in a normal context with a normal lifestyle. Pseudo incontinence (encopresis) can be treated with disimpaction followed by laxative therapy. True incontinence requires an enema program, with treatment tailored to either hypo or hypermotile colons. Bowel management is a treatment program which has been purposely conceived for children born with imperforate anus; however, it can be applied to all children with fecal incontinence.
Surgery for pseudo incontinence, which is rarely required, takes the form of colonic resection but only for patients with a demonstrated ability to have voluntary bowel movements, albeit with enormous laxative requirements. Removal of the rectosigmoid in this situation can reduce or eliminate the need for laxatives. Surgery for true fecal incontinence involves changing the route for a successfully demonstrated enema program to an antegrade, i.e., a Malone appendicostomy.
Get more information or request an appointment for the Colorectal Center. Contact us.
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