• Bowel Management Program

    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 often remarkable.

    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.

    Overview Video

    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. 

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    Patients 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.