Management and Treatment
Management and treatment involves distinguishing between true and pseudo bowel 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.