Ways to achieve bowel continence
What is Bowel Continence?
Bowel Continence is the ability to stay clean in between bowel movements. Many people who have disabilities of some kind are not able to achieve bowel continence with out some kind of intervention. Let me introduce myself so you can feel comfortable learning what you can from me. My name is Lisa and I have learned with bowel management for my daughter how to achieve bowel continence. My daughter was born with multiple birth defects with included a tethered spinal cord. She has been in end stage renal failure resulting in dialysis for the last four years( she is almost 8 now) and some other things that go along with her condition. She was severely incontinent resulting in bowel movements almost constantly. She always had skin breakdown and the worst was seeing her suffer with the pain from her burnt bottom. Her father and I read the internet and talked to other parents and doctors and we learned a lot. We learned of some different surgical procedures and some a little less invasive. There are many options that you should discuss with your medical provider.
With my daughter being in pediatrics I have been blessed with a team of truly amazing people who have taught me things I would never have imagined I would need to know. Several years ago we spent almost a whole year living in the hospital trying to get continence problems under control. She would go so much that her electrolytes were out of whack always. It was a very difficult balancing act and because he condition is so complicated it took many teams of doctors and nurses to come up with what would eventually work for her.
One of the first attempts at bowel management started with medication. We used a light laxative powder daily and a piece of ex-lax a few times a week. Honestly this was a disaster. We switched GI doctors more times than we could count because they were insistent on continuing that pattern that just made her go more and more. She never got cleaned out with that. What was really happening was that she was so constipated the laxatives made he stool around blockages of feces and she just leaked all the time. Her father and I knew this was torture for her so we kept researching. We knew of a doctor in another state who did "Bowel Management" and we read everything he had to offer. This information can easily be found on many websites but I know if you search for the Cincinnati Children's Hospital they have so much information there. So our journey began to tell our doctors and get them on the same page as us. Many years later we are at 2 years of bowel continence. Every now and again she has a small accident but that usually comes with certain foods as with anyone don't always agree with us. So as I mentioned before we have some really great doctors on our team and our pediatric surgeon has actually written books with his knowledge of bowel management so our journey began with him. After much time he convinced our local hospital to have his ARNP trained in to teach his patients "Bowel Management" . We spent two nights in the hospital training and have been doing it at home ever since.
Bowel Management consists of a few things. Like I said before a medical professional would have to access your specific needs as some people have had reconstructive types surgeries and other disabilities. So its a bit more detailed than a basic daily enema. You will start with a Silicone Foley catheter (with a balloon) and and enema cleansing bag set. We use a combination of normal saline and sterile water. (we have a prescribed amount) Insert like an enema but we fill the balloon with about 25 cc of air so that it stays in place for about 10 minutes then we got the bathroom take out the catheter and sit for about a half hour. We still use a small amount of laxative on a daily basis just to keep everything soft and at bedtime she drinks(she has a gtube so really she just puts in her tube but anyone could drink) pectin. We use the Ball brand pectin because it mixes easily with water and the price is right. The pectin is used because it is used to make jelly and if the feces is that type consistency you are less likely to have any unexpected leakage. It took a little trial and error in the beginning on how much solution to use, how much pectin to use but once we figured all that out our entire lives changed.Before going out was very difficult as we spent most of the day in the bathroom changing diapers or looking for a bathroom.Now we can go out for the day and enjoy what ever we choose.
Where we learned everything from
The Colorectal Center’s Bowel Management Program at Cincinnati Children’s helps patients who are unable to anticipate or control their bowel activity to improve their quality of life.
- Bowel Management Program Overview
This is a complete overview of the bowel management program
- My Healthcare at USF - USF Health
An excellent group of doctors and nurses who truly know how to make a patient a priority. They have improved my child's quality of life in ways you could not imagine.