Pediatric Bowel Management Program

Pediatric Bowel Management Program

Our team helps children with colorectal and pelvic conditions, including anorectal malformations and Hirschsprung disease, achieve bowel control using proven methods that get results.

Some children are born with certain conditions, such as anorectal malformations and Hirschsprung disease, that make it hard for them to control their bowels – even after successful surgery. These conditions affect the bowels and pelvis and can cause long-term problems, including constipation, diarrhea and stool (poop) accidents.

At the Children’s Health℠ Colorectal and Pelvic Center, our experienced team offers an intensive bowel management program for children and their caregivers. We designed our 8-day outpatient program specifically for children with anorectal malformations (ARM), Hirschsprung disease, cloacal malformations and other pelvic conditions. During this program, we teach you and your child the techniques to help prevent stool accidents. Our goal is for your child to be able to stay clean in their underwear so they can enjoy their daily activities accident-free.

Difficulty with bowel control (called fecal incontinence) can affect your child’s daily life at home and in school, friendships and other social situations. Our customized treatment plans not only support bowel management, but also enhance your child’s social-emotional development, mental health and overall well-being. We’re dedicated to supporting your family with care that improves your child’s quality of life.

What is bowel management for children?

Bowel management helps children at toilet-training age who are having difficulty achieving bowel control (continence) or experience severe constipation. Our Bowel Management Week is designed for these children once they reach an age-appropriate time to be out of diapers, such as preschool age. Our team creates a customized plan to ensure that your child has daily bowel movements and can stay clean, without accidents.

A successful bowel management plan includes therapies that work together to help your child achieve bowel control. Depending on their specific needs, your child may need one or more therapies, such as laxatives, enemas, fiber, antidiarrheal medications and dietary changes.

Conditions We Treat

  • Surgically Related Rectal Prolapse
  • Surgically Related Constipation/Fecal Incontinence

Treatments and Services

  • Enema program
  • Laxative program
  • Hypermotility/diarrhea program
  • Nutrition counseling

What to expect from our bowel management week

We offer Bowel Management Week once a month for eight consecutive days, starting and ending on a Thursday. Here’s an overview of what you can expect during our program.

What to expect before bowel management week

We’ll have you review our Guide for Bowel Management Week and Frequently Asked Questions about two weeks before your first appointment so you can understand the program. Please download these documents:

On Wednesday, the day before the week-long program begins, you’ll bring your child in for a contrast enema study. This study involves giving a rectal enema with a contrast liquid that shows up on an X-ray. We use contrast enemas to assess the size and structure of your child’s colon (large intestine).

Day 1 of bowel management week

During your first office visit, we will:

  • Explain the program and answer your questions.
  • Do a physical exam of your child and review their medical history with you.
  • Review the contrast enema and take an abdominal (belly) X-ray to see the amount of stool in your child’s colon before the program begins.
  • Work with you to develop a regimen for your child.
  • Show you how to start the program at home and keep a diary to record important information to share with us at your visits throughout the week.

Today and throughout the week, you and your child can meet with our social worker, registered dietitian and Child Life Specialist for support and guidance.

Days 2–4 of bowel management week

You’ll start your child’s treatment regimen at home on Friday, Saturday and Sunday. During this time, you will:

  • Give your child their treatment at the same time each day.
  • Record details in the diary about your child’s stool, including whether they have any discomfort with the treatment, accidents or any other problems. It’s also important to note any changes in their diet that might be affecting their stooling.

Days 5–7 of bowel management week

You’ll continue to work closely with our team each day for the rest of Bowel Management Week. For this part of the week, typically Monday through Wednesday, you will:

  • Take your child for an abdominal X-ray, either at our offices in Dallas or Plano or at a radiology center near you if you live outside the area.
  • Receive a call from our nurse to review your diary and the X-ray and discuss your child’s progress.
  • Receive our recommendations for adjusting your child’s regimen based on what the X-rays show and how they’re doing.

Day 8 of bowel management week

For your last visit, typically on Thursday, you and your child will either come in or have a virtual visit on video. That day, you will:

  • Take your child for their last X-ray.
  • Meet with our team to confirm an ongoing treatment plan for your child’s bowel management.
  • Schedule a follow-up clinic visit in three months to check on your child's progress with the new program.

Upcoming dates for bowel management week

At the Colorectal and Pelvic Center, we’re offering Bowel Management Week on these dates. Contact us to find out more details and register.

  • January 4–11, 2024
  • February 8–15, 2024
  • March 7–14, 2024
  • April 4–11, 2024
  • May 16–23, 2024
  • June 27–July 4, 2024

Why choose Children’s Health for bowel management?

At the Colorectal and Pelvic Center, we understand how colorectal conditions can affect a child’s quality of life. We work intensively with you and your child to provide specialized care and support as you manage their complex condition.

Highlights of our program include:

  • Multidisciplinary team of experts. Our team includes pediatric surgeons, nurse practitioner, nurse/program manager and social worker. With training and experience in treating the conditions that lead to bowel incontinence, we take a comprehensive approach that supports your child’s body, mind, and spirit. We work with other specialists for comprehensive care, including registered dietitians, pelvic floor therapists and gastrointestinal providers.
  • Specialized care close to home. The week-long intensive program in our Dallas clinic is the only bowel management program in North Texas. We also see patients and do X-rays in Plano, and we manage patients from outside the Dallas-Fort Worth area. If you live far from Children’s Health, your child can have their daily X-rays at a radiology center near you. We can manage their care through virtual visits after the first in-person office visit.
  • Psychology, Child Life and social work support. You and your child can work with our dedicated psychologist, Child Life specialist and social worker for additional emotional support. These providers can help your child understand the condition, manage the challenges that come with bowel issues and feel comfortable about their treatment. Our social worker can help with lodging and other resources if you’re traveling to Children’s Health from a long distance.
  • Ongoing bowel management support. Outside of our Bowel Management Week, our team provides ongoing care for children who had surgery to treat anorectal malformations, Hirschsprung disease, cloacal malformations and related conditions. We monitor them every few months for constipation and other issues as their diet changes from infancy to toddlerhood. At the appropriate time, we schedule them for Bowel Management Week. Then we continue to manage their care as they become teens and young adults, adjusting their bowel management regimen as needed over the years.

Meet the Care Team