Cedars-Sinai Pediatric Bowel Management Program uses new techniques to manage fecal incontinence

Cedars-Sinai Medical CenterApr 25 2014

The new Pediatric Bowel Management Program in Cedars-Sinai's Maxine Dunitz Children's Health Center, is using innovative techniques to successfully manage fecal incontinence in children born with colorectal disorders.

Although parents can find it difficult and embarrassing to discuss their children's bowel problems, congenital anorectal malformations occur in nearly one in 5,000 live births, said Philip Frykman, MD, PhD, associate director of pediatric surgery at Cedars-Sinai. The Pediatric Bowel Management Program, the only one of its kind in California, employs a multidisciplinary team with specially trained nurses to help pediatric patients who are unable to anticipate or control their bowel activity.

"Our goal is to empower children to manage their bodily functions and thus improve the quality of life for these kids and their families," Frykman said. "Parents and kids don't need to suffer; there are effective treatments that result in improved social acceptance and higher self-confidence."

Lynn Kataoka opted for bowel management surgery for her seven-year-old daughter, Ella. Prior to the surgery, Ella was in diapers, regularly constipated and in pain. Now Ella is able to wear underwear and enjoy the daily life of a seven year old. Kataoka says "the surgery was a life changing experience."

Frykman says Kataoka's story is not unusual considering the program has a 90 percent success rate. For many patients, innovative use of medications, surgical procedures and behavioral modification, like learning to recognize body cues, can help children achieve what Frykman calls "social continence" -- the ability to attend school wearing normal underwear and remain clean for 12-24 hours.

"Often, when parents are confronted with this issue, they can mistakenly believe the child is willfully refusing to learn how to properly control themselves," said Frykman, associate professor of biomedical sciences, associate professor of academic affairs and assistant clinical professor of surgery. "But we are finding that more often than not, there is a physical, medical problem standing in the way. If we can pinpoint the problem, the solution isn't far behind.

"Seeking medical attention when bowel management issues first surface can help children avoid a permanent colostomy or lifelong dependence on diapers," he added.