Evaluation and Treatment

The keys to success of the bowel management program are dedication and sensitivity from the medical team. The basis of the program is to clean the colon and keep it quiet, and thus the patient remains clean for the 24 h after the enema, colonic irrigation, or suppository that is given once a day. Sometimes manipulation of diet and medication are utilized for patients with a hypermotile colon.

The program is an ongoing process that is responsive to the individual patient and differs for each child. The program is usually successful within a week, during which family, patient, physician, and nurse undergo a process of trial and error, tailoring the program to the specific patient. More than 90% of the children who follow this program are artificially clean and dry for the whole day and can lead a completely normal life. It is unacceptable to send a child with fecal incontinence to school in diapers when his classmates are already toilet trained, and proper treatment to prevent this is perhaps more important than the surgical procedure itself. Children who require diapers or who have accidents while in school because of fecal incontinence are exposed to ridicule from their peers, which can lead to adverse psychological sequelae.

The first step is to perform a contrast enema study with hydrosoluble material. The study should never be done with barium; it is also important to obtain a picture after the evacuation of the contrast material. This study shows the type of colonic motility, hypomotility - constipated (Fig. 29.1) or hypermotility (Fig. 29.2).

The bowel management program is then implemented according to the patient's type of colon, and the results are evaluated every day. Changes in the volume and content of the enemas are made until the colon is successfully cleaned. For this, an x-ray film of the abdomen, taken every day, is invaluable in determining whether the colon is empty.

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Colon Cleanse

Colon Cleanse

Before delving into what colon cleanse is, is it not wiser to get an idea of what your colon does? That way, you will better understand why getting your colon cleansed is immensely important. In this article, we will be discussing the colons role in the digestive function of the intestinal tract. Colon cleansing and its benefits will also be discussed.

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