Bowel Management Treatment Program

What is the Bowel Management Treatment Program?

We have a one-week outpatient program to help children and teens control their bowels without having accidents or needing to wear a diaper. The Bowel Management Treatment Program helps patients ages 3 to 21 who may have trouble controlling their bowels because of a condition affecting their pelvic area. This includes patients with Hirschsprung disease, imperforate anus, idiopathic constipation, neurogenic bowel and bladder or other pelvic problems.

How will the Bowel Management Treatment Program help?

Trouble with bowel control (fecal incontinence) can lead to struggles at home, in school, in friendships and with emotions, behavior and mental health. Many incontinent children can be more active, social, happy and independent if they have a plan for bowel management that works for them.

Our program relies on methods shown to achieve results. We carefully adapt these methods to find the right balance for your child. At the end of the week, you and your child leave with a clear plan that you can use at home - and that may change your child's daily life for the better. After your week here, we follow up with you by phone several times during the first year and then once a year after that.

Focusing closely on bowel management every day for one week provides a better chance of success. The week-long approach we use is based on a program developed by Dr. Alberto Pena at Cincinnati Children's Colorectal Center. Our providers trained with and continue to work with Pena and his team to improve the program and quality of life for more children.

Your week here is a chance to connect with other families who are dealing with the same issues you face. There is a support group for parents in the program during the week so you can share experiences and ideas.

How does the Bowel Management Treatment Program work?

• On a Friday, children and parents in the program come to Seattle Children's for a group overview about bowel management. Our doctors and nurses explain the medicines, enemas and diets we use. Each family has a one-on-one clinic visit with a provider from the program to make a plan for their child.
• Over the weekend, the family practices their plan.
• Starting on Monday, your child comes to Children's for a bowel X-ray each morning for five days. This helps us check whether your child's plan is working. A nurse from our program also talks with you by phone each morning. Each afternoon our team meets to discuss your child's results. If needed, we adjust your child's plan, and the nurse calls you to explain the plan.
• At the end of the week, you and your child come for a clinic visit to talk about your child's progress.

Our goal is for your child to empty their bowel daily with no accidents by the end of the week. Nearly every child in our program meets this goal. Success depends on your child's condition and following your plan closely. School-age children in the program stay home from school for the week, and we recommend that parents stay home from work this week as well. Families need to stay in the Seattle area near the hospital to come for daily X-rays.

• Read Bethany's story.

Who's on the team?

Members of our Reconstructive Pelvic Medicine team will work with you and your child on bowel management. Providers in the Bowel Management Treatment Program include:

These team members have special expertise in treating children's pelvic conditions and making bowel management plans with families. When you come to Seattle Children's, you get their combined knowledge and experience. They work with each other and with you to create a plan that meets your child's needs.

To find out about joining the program, ask your child's doctor to refer your child here, or call Reconstructive Pelvic Medicine at 206-987-2794, option 4. Before your child enters the program, the team does a full evaluation to understand your child's condition and tell whether they might benefit from the program.