Bowel Management Resources from The Hendren Project
►El Curso en Español
Learning Objectives
Bowel Management Course for Patients, Parents, and Medical Professionals is an international webinar designed specifically for patients, family, and medical professionals that explores many of the multidisciplinary challenges of treating and managing bowel management in pediatric patients. Attendees learn how to understand how to manage and live effectively with these complex medical conditions.
Presentations generally address:
1. Descriptions of the multidisciplinary challenges and successes of managing bowel management in pediatric patients.
2. Descriptions of advances in improving quality of life for patients.
3. Descriptions of living effectively with complex pediatric surgical conditions.
Program
What Is Bowel Management and Which Patients Benefit? ►en Español
Andrea Bischoff, MD
Director, International Center for Colorectal Care, Children's Hospital Colorado, Aurora, CO
Professor, University of Colorado, Anschutz Medical Campus, Aurora, CO
Bowel management programs are designed to help children establish regular and controlled bowel movements. Bowel management involves a combination of dietary changes, medications, enemas, and behavioral modifications to prevent complications like constipation, fecal incontinence, or impaction. The goal is to improve bowel function, enhance quality of life, and prevent social and medical issues related to poor bowel control. Pediatric patients with congenital, neurological, and functional disorders affecting bowel function benefit most from bowel management programs.
Bowel Management: Significance of the Abdominal X-ray and the Contrast Enema ►en Español
Luis de la Torre, MD
International Center for Colorectal Care, Children's Hospital Colorado, Aurora, CO
Associate Professor, University of Colorado, Anschutz Medical Campus, Aurora, CO
An abdominal radiograph provides a clear, objective picture of the gastrointestinal tract. This imaging tool helps clinicians assess the distribution of gas and fecal material, identify signs of obstruction, and evaluate overall bowel motility. With these insights, healthcare providers can tailor treatment plans—such as adjusting laxative use, dietary modifications, or considering interventions—to effectively manage and resolve bowel issues.
Contrast enemas play a crucial role in bowel management programs for pediatric patients, especially those with conditions such as Hirschsprung disease, spina bifida, anorectal malformations, or chronic constipation. Contrast enemas help visualize the structure and function of the colon, identifying anatomical abnormalities such as strictures, obstructions, megacolon, or motility issues. They guide treatment plans, prevent complications, and provide post-surgical assessment of complex surgical conditions. By providing a clear image of the bowel’s condition, contrast enemas help educate caregivers on the child’s condition and the importance of adherence to bowel management protocols.
What Is Bowel Control? What Is Fecal Incontinence (with Hypermotility and Hypomotility)? ►en Español
Andrea Bischoff, MD
Director, International Center for Colorectal Care, Children's Hospital Colorado, Aurora, CO
Professor, University of Colorado, Anschutz Medical Campus, Aurora, CO
Bowel control refers to the ability of a child to voluntarily regulate bowel movements, preventing accidents and maintaining continence. It typically develops by age 3-4 as the nervous system matures and children learn to coordinate their pelvic floor muscles and anal sphincter. However, some children struggle with bowel control because of congenital, neurological, or functional disorders, leading to fecal incontinence—the involuntary loss of stool.
What Is Constipation? ►en Español
Luis de la Torre, MD
International Center for Colorectal Care, Children's Hospital Colorado, Aurora, CO
Associate Professor, University of Colorado, Anschutz Medical Campus, Aurora, CO
Constipation is a common gastrointestinal problem in children, characterized by infrequent, difficult, or painful bowel movements. It can be acute (short-term) or chronic (long-lasting) and may lead to complications such as fecal impaction and encopresis if not managed properly.
Enemas. Indications: How To Perform Them? ►en Español
Anne Merritt, RN, CPN, AMB-BC
Children's Hospital Colorado, Aurora, CO
Enemas are used as a treatment for constipation and fecal impaction in children when other methods, such as dietary changes and oral laxatives, are ineffective. They help stimulate bowel movements and provide rapid relief in cases of severe constipation or neurogenic bowel dysfunction.
How To Perform Rectal Irrigations ►en Español
Amy Krause, RN
Associate Professor, University of Colorado, Anschutz Medical Campus, Aurora, CO
Rectal irrigation is a medical procedure to cleanse the lower bowel by introducing a controlled amount of fluid into the rectum and colon. It is commonly used for children with chronic constipation, fecal incontinence, or neurogenic bowel dysfunction (e.g., spina bifida, Hirschsprung disease, or spinal cord injury). It helps remove stool, prevent impaction, and promote regular bowel movements.
How To Treat Fecal Incontinence ►en Español
Andrea Bischoff, MD
Director, International Center for Colorectal Care, Children's Hospital Colorado, Aurora, CO
Professor, University of Colorado, Anschutz Medical Campus, Aurora, CO
Fecal incontinence in children, also known as encopresis, is the involuntary leakage of stool. It can be organic (caused by an underlying medical condition) or functional (without anatomical or neurological abnormalities). The treatment approach depends on the underlying cause, but the goal is to restore bowel control, improve quality of life, and prevent social distress.
How To Treat Constipation ►en Español
Luis de la Torre, MD
International Center for Colorectal Care, Children's Hospital Colorado, Aurora, CO
Associate Professor, University of Colorado, Anschutz Medical Campus, Aurora, CO
Constipation is a common condition in children, characterized by infrequent, hard, or painful stools. It can lead to abdominal discomfort, stool withholding, and even fecal incontinence (encopresis) if not properly managed. The goal of treatment is to relieve constipation, establish regular bowel habits, and prevent recurrence.
What To Know About Bowel Management for Spina Bifida Patients: How Are These Patients Different?
Betsy Dunbar, PA-C
University of Colorado, Anschutz Medical Campus, Aurora, CO
Spina bifida is a congenital condition affecting the spinal cord, often leading to neurogenic bowel dysfunction. Because of nerve damage, children and adults with spina bifida lack voluntary bowel control, have slow intestinal motility, and may experience severe constipation or fecal incontinence. Managing bowel function is critical for maintaining health, hygiene, and quality of life, but it comes with several challenges.
Surgical Procedures in a Bowel Management Program ►en Español
Luis de la Torre, MD
International Center for Colorectal Care, Children's Hospital Colorado, Aurora, CO
Associate Professor, University of Colorado, Anschutz Medical Campus, Aurora, CO
For children with severe bowel dysfunction, surgical procedures may be necessary when conventional treatments (diet, medications, enemas, and bowel training) fail to provide adequate bowel control. These procedures aim to improve continence, reduce constipation, and enhance quality of life by facilitating effective stool evacuation.
Promoting Success with a Bowel Management Program ►en Español
Laura Judd-Glossy, PhD & Kristina Matkins, LCSW
University of Colorado, Anschutz Medical Campus, Aurora, CO
Children with bowel management challenges, such as constipation, fecal incontinence, or neurogenic bowel dysfunction, often face psychological and social difficulties in addition to medical concerns. These challenges can affect their self-esteem, social interactions, emotional well-being, and quality of life. Addressing these issues is crucial for the mental health and overall development of the pediatric patient.
Question & Answer Session ►en Español