Candidates For Bowel Management
Children who suffer from fecal incontinence after the repair of an imperforate anus are usually those born with a bad prognosis type of defect and severe associated defects (defect of the sacrum, poor muscle complex). However, such children can still achieve a good quality of life when treated with the bowel management program. Children operated on for imperforate anus and who suffer from fecal incontinence can be divided into two groups that require individualized treatment plans:
Children with Constipation (Colonic Hypomotility) No special diet or medications are necessary for children with colonic hypomotility, a type of constipation. Their tendency towards constipation helps them to remain clean between enemas. The real challenge is to find an enema capable of cleaning the colon completely. Soiling episodes or "accidents" occur when there is an incomplete cleaning of the bowel.
Children with Loose Stools and Diarrhea (Colonic Hypermotility) This group of children has an overactive colon. Rapid transit of stool results in frequent episodes of diarrhea. This means that even when an enema cleans the colon rather easily, stool keeps on passing fairly quickly from the cecum to the descending colon and the anus. To prevent this, a constipating diet and/or medications to slow down the colon are necessary. Eliminating foods that further loosen bowel movements will help the colon to slow down. Those who experience hypermotility may have to follow a constipating diet and avoid laxative foods. The diet is rigid and includes food such as banana, apple, baked bread, white pasta with no sauce, boiled meat, and others, while fried foods and dairy products are avoided.
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