Bowel Management Program

Our Bowel Management Program is a one-week outpatient program for children who are unable to anticipate or control their bowel activity. After children participate in this intensive program, many of them are in normal underwear by the end of the week! By maintaining bowel management after the program ends, these patients can avoid bowel accidents, bed-wetting  permanent colostomy and dependence on diapers. The improvement in self-esteem and quality of life is often remarkable. This program is designed primarily for children age three-years-old and up.

an image of two parents standing over their child, changing its diaperMake an appointment

Please call our Referral Center to schedule an appointment, call (916) 453-2191 or via email at A Referral Coordinator will partner with you to gather the necessary information to allow our physician leadership to evaluate the best path for your child. The key to success is dedication, timing and teamwork between the patient, families and medical team. We tailor each child’s regimen to their specific needs. Each child’s outcome will depend, in part, on the severity of their condition.

Patient Evaluation

Patients are seen in our Sacramento hospital clinic where the Pediatric Surgery team evaluates each patient and develops a treatment plan based on the individual needs of each child. At Shriners Hospitals for Children – Northern California, care is delivered in a hospital designed specifically to serve the medical and emotional needs of children and their families.


Anorectal Malformations (Imperforate Anus)
Fecal incontinence
Hirschsprung disease
Overactive bladder

What is the Bowel Management Program?

Our Bowel Management program is an outpatient program to help children and teens control bowel issues without having accidents or needing to wear a diaper. This program is for patients ages 3 to 18 who may have trouble controlling their bowels because of a condition affecting their pelvic area. This includes patients with Hirschsprung disease, imperforate anus, idiopathic constipation, neurogenic bowel and bladder or other pelvic problems.

How will the Bowel Management Program help?

Trouble with bowel control (fecal incontinence) can lead to struggles at home, in school, in friendships, with emotions, behavior and mental health. Many incontinent children can be more active, social, happy and independent if they have a plan for bowel management that works for them.

Our program relies on methods shown to achieve results. We carefully adapt these methods to find the right balance for your child. We want you and your child to leave with a clear plan that you can use at home – and that may change your child’s daily life for the better. We follow up with you by phone several times during the first year and then once a year after that.

Focusing closely on bowel management during the program provides a better chance of success. The approach we use is based on a program developed by Dr. Alberto Pena at Cincinnati Children’s Colorectal Center.

How does the Bowel Management Program work?

  • On the first visit, parents and children come to our Sacramento hospital for a group overview about bowel management. Our doctors and nurses explain the medicines, enemas and diets we use. Each family has a one-on-one clinic visit with a provider from the program to make a plan for their child.
  • When deemed appropriate, your child will have bowel X-ray. This helps us check whether your child’s plan is working. A nurse from our program will talk with you either in person or by phone to discuss your child’s results.

Our goal is for your child to empty their bowel daily with no accidents by the end of the week. Nearly every child in our program meets this goal. Success depends on your child’s condition and following your plan closely. Families may need to stay in Sacramento to be near the hospital so they can come in for X-rays.

Who is on the team?

Members of our team will work with you and your child on bowel management. Providers in the Bowel Management Treatment Program include:

Diana Farmer, M.D.
Pediatric Surgeon, Surgeon in Chief

Shinjiro Hirose, M.D.
Director, Pediatric Surgery

Jacob C. Langer, M.D.
Visiting Pediatric Surgeon

Payam Saadai, M.D.
Pediatric Surgeon

Veridiana Bussani, RN
Case Manager

These team members have special expertise in treating children’s pelvic conditions and making bowel management plans with families. When you come to Shriners Hospitals for Children – Northern California, you get their combined knowledge and experience. They work with each other and with you to create a plan that meets your child’s needs.

To find out about joining the program, talk with your child’s doctor about a referral, or call (916) 453-2191. Before your child enters the program, the team does a full evaluation to understand your child’s condition and determine whether they might benefit from the program.

Patient Referral

916-453-2111 (Emergency Referral)
916-453-2395 (fax)

a graphic of some silhouettes of children playing