Bowel Management

Intensive Bowel Management Program

Our Bowel Management Program is a one-week outpatient program for children who cannot control their bowel activity. The goal is to help children achieve bowel control by using laxatives and/or enemas and, in some cases, medication and an individualized special diet.

Each year, approximately 250 children from all over the world participate in this intensive program. Many of them are in regular underwear by the end of the week! Although the program is designed primarily for children 3 years and older, many adults have completed it with success.

The Bowel Management Program is often a good fit for patients with the following conditions:

By maintaining bowel control long-term, patients can avoid bowel accidents, permanent colostomy and dependence on diapers. The improvement in self-esteem and quality of life is often remarkable.

Bowel Management Program Overview

The Bowel Management Program takes place twice a month. Before participating, your child may undergo a test to evaluate their motility (how food moves through the colon).

The key to success is dedication, timing and teamwork among the patient, families and medical team. We tailor each child’s regimen to their 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.

What to Expect

The program begins on a Friday and ends the following Friday, involving daily visits to Cincinnati Children’s. During the late afternoon on Thursday (the day before the program begins), families meet with a nurse or nurse practitioner to review the program, talk about expectations and ask any questions they may have. Some children undergo a contrast enema that day as well.

On the first Friday of the program, you and your child will meet with one of our colorectal providers and a nurse from the Colorectal Center to establish a treatment plan for the week.

Each weekday, your child will come in for an abdominal X-ray to determine how empty the colon is of stool. Our doctors and nurses meet daily to review these imaging results and adjust the treatment plan as needed for your child.

Using our program’s digital smartphone app or a paper log, you and your child will report medications, symptoms and bowel movements to share daily with the care team.

Education is a big part of the Bowel Management Program. Each day throughout the week, a nurse will speak with you and your child to answer questions and provide information about maintaining the program regimen long-term.

We also offer an optional parent and caregiver support group midweek, led by our licensed social worker. She will ask questions about family support and quality of life and can connect you with resources as needed.

During the Bowel Management Program, your child may see specialists from other areas of the hospital, such as nutrition, gastroenterology, pelvic floor physical therapy, and behavioral medicine and clinical psychology. Offering collaborative care from other specialists is all part of our commitment to ensuring the best outcome possible for your child.

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Enema Demonstration

Watch a video providing step-by-step instructions for administering a rectal enema. Remember: enemas should not be painful.

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