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.

At Shriners Hospital for Children Northern California, we understand that each child is unique and different. Together, we work with patients and families to create the best possible outcome. The goal of our program is to have every child be clean and in underwear.

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 ncal.info@shrinenet.org. 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.

Why our team is different

Our team includes a multidisciplinary approach to care. When your child is seen in our Colorectal and Bowel Management Program, they have the input of social workers, child life specialists, nurses, dieticians, and physicians. We run a weekly multidisciplinary meeting discussing all of the upcoming patients to make sure that each child receives the input of each of our team members, even if you don’t meet one-on-one with each of these different specialists.

Conditions We Treat

Anorectal Malformations (Imperforate Anus)
Hirschsprung disease
Fecal incontinence
Constipation
Diarrhea
Bed-wetting and overactive bladder, if related to constipation

What is the Bowel Management Program?

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.

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 is designed with YOU in mind.

  • Outpatient
    • At the initiation of our program, families meet in a group setting led by the Nurse Case Manager, along with a registered dietician and child life specialist. During this educational visit, the patient and their parent will receive information on the program, the work-up for constipation, dietary changes to improve constipation, and how to help the child cope with their diagnosis.
    • Further visits are conducted one-on-one with a medical provider within our team.
  • Inpatient
    • When patients have severe constipation, or who have not achieved success on an outpatient basis, we offer an intensive inpatient program tailored to the unique needs of each patient and family.
    • After the hospitalization, the child is discharged with a clear treatment plan in place. Further follow-up appointments are conducted one-on-one with a medical provider from our team.

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:

Shinjiro Hirose, M.D.
Director, Pediatric Surgery

Payam Saadai, M.D.
Pediatric Surgeon

Erin Brown, M.D.
Pediatric Surgeon

Alana Beres, M.D.
Pediatric Surgeon

Arthur de Lorimier, M.D.
Pediatric Gastroenterologist

Jennifer Miranda
Nurse Practitioner

Kat Swartz
Nurse Practitioner

Carolyn Wilson
RN Care Manager

Sarah McCullum
Registered Dietician

Kat Davis
Outpatient Child Life Specialist and owner of Yogo

Yogo
Therapy and Support Dog

Sarah Ferrin
Inpatient Child Life Specialist

Courtney Krackie
Licensed Clinical Social Worker

Aime Andrade
Medical Assistant and patient scheduler

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.

Make an Appointment

Please call our Referral Center to schedule an appointment, call (916) 453-2191 or via email at ncal.info@shrinenet.org. 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.
a graphic of some silhouettes of children playing