If your child has bowel incontinence due to spina bifida or another congenital birth defect that affects the spine, their treatment plan will likely consist of a combination of different approaches. This may include changes in diet, lifestyle, medications, surgery and participating in a bowel management program.
Our Bowel Management Program implements a customized set of treatments to help your child achieve the ability to stay clean and free from accidents. Your child benefits from working with nutritionists who create optimal diet plans and who offer helpful tips for increasing fiber intake for parents who have kids that are picky eaters. A nurse practitioner and child psychologist oversees treatment plans and makes adjustments as needed.
Other non-surgical treatments include:
- Enemas and bowel irrigation treatments to loosen stool and flush out waste
- Medications such as laxatives if needed
- A healthy fiber-rich diet
If your child requires surgery, surgical treatments include:
A Malone appendicostomy (MACE) is a procedure where your surgeon constructs a valve, or pathway from the belly button to the colon by connecting the appendix to the abdomen. The procedure does not entail the use of any artificial implants or devices because the valve is created using your child’s own tissue. A catheter is placed in the valve where a special solution is administered to flush the colon of stool. Following MACE, your child will spend about two days in the hospital and require follow up visits with your surgeon at one month to ensure they are healing properly.
Sometimes the appendix can be split and used for both the Malone and the Mitrofanoff appendicostomies (similar idea for access to the bladder), and on occasion the segment of the colon to be removed can be added to the bladder to make it larger (bladder augmentation).
A colon resection may be performed to remove areas of the colon that are diseased, which may include areas of the large intestine, small intestine or rectum. The type of colon resection needed will depend on your child’s specific spinal disorder and the severity of their condition. Your child will typically spend one week in the hospital following a colon resection and require a one month follow-up to ensure they have healed properly and to check for any possible complications.