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The Bowel Management Program at
the Peña Colorectal Center is a one-week outpatient program for children who
are unable to anticipate or control their bowel activity. Each year, approximately 250
children from all over the world participate in this intensive program, and many of them are in normal
underwear by the end of the week! By maintaining bowel management after the
program ends, these patients can avoid bowel accidents, permanent colostomy and
dependence on diapers. The improvement in self-esteem and quality of life is
Although the program is designed
primarily for children age three and up, many adults have completed it with
success. The Bowel Management Program is often a good fit for patients with:
The key to success is dedication,
timing and teamwork between the patient, families and medical team. We tailor each
child’s regimen to his or her specific needs. Each child’s outcomes will depend
in part on the severity of their condition. While some children may achieve
bowel control through diet, some will continue to need laxatives and/or enemas.
Our Bowel Management Program is an
intensive, week-long program offered once a month at Cincinnati Children’s. The
goal is to help children achieve bowel control through the use of laxatives
and/or enemas and, in some cases, medication and an individualized diet.
Prior to participating in this
program, your child will undergo a test to evaluate the motility of his or her
colon — how food moves through the colon. Based on the test results and
your child’s history, our team will develop a specific regimen for your child
to follow during the Bowel Management Program.
The program begins on a Friday and
ends the following Friday, and involves daily visits to Cincinnati Children’s. On
the first day, you and your child will meet with one of our surgeons and a
nurse from the Peña Colorectal Center to establish a plan of treatment for the
week. Each day, your child will come in for an abdominal X-ray to determine how
empty the colon is of stool. Our doctors and nurses meet every day to review
these test results and make adjustments to the treatment plan as appropriate
for your child. You and your child will see the doctor on the first and last
day of the program.
Education is a big part of the
Bowel Management Program. Throughout the week, a nurse will speak with you and
your child daily to answer questions and provide information about maintaining
the regimen long term. Most of the children who complete this program will need
to maintain a bowel management regimen for their entire lives. We are committed
to helping them be successful, and we provide continued support to families
after the patient completes the Bowel Management Program.
Some patients who must continue
using enemas long term eventually decide to undergo an appendicostomy (or
Malone procedure). This surgery involves creating an opening in the abdomen so
that the enema can be delivered through a catheter rather than through the
rectum. This means that the patient can administer his or her own enema, rather
than relying on someone else to help.
Listen to Dr. Alberto Pena as he provides an overview of our Bowel Management Program, including the different categories of patients they treat and overall goals of the program.
with spina bifida occulta, myelomeningocele and traumatic spinal cord injury
often experience fecal incontinence. Our experienced physicians and nurses are
very familiar with the unique challenges that these patients face in achieving
bowel control. We tailor every treatment plan to help patients achieve success,
no matter what their physical challenges.
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