Bowel Management for the Treatment of Fecal Incontinence

  • Alberto Peña
  • Andrea Bischoff


Unfortunately, after the repair of anorectal malformations, many patients suffer from significant sequelae, and the most feared of those is fecal incontinence, followed by urinary incontinence and sexual problems. A critical analysis is presented of the different therapeutic methods that different authors use to deal with the sequelae including biofeedback, electrical stimulation, and behavior modification. At the end, the authors present the “bowel management program” used at their institution; this is a detailed description of the methodology that the authors believe allows to improve the quality of life of many fecally incontinent patients at a relatively low cost.


Fecal Incontinence Anorectal Malformation Contrast Enema Tethered Cord Urethral Diverticulum 
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Supplementary material

Animation 20.1

Animation showing the basic principles and rationale to the use of enemas. The enema cleans the colon in about 30–45 min. The new stool travels from the cecum to the rectum in more than 24 h. And therefore, the patient remains clean in between enemas (WMV 24480 kb)

Animation 20.2

Animation showing the effect of an enema in a patient with hypermotility. The enema cleans the colon, but the new stool travels from the cecum to the rectum in less than 24 h, and that is the reason why the patient passes stool in the underwear in between enemas (WMV 22496 kb)

Animation 20.3

Animation showing the management of patients suffering from fecal incontinence and colonic hypermotility. The enema cleans the colon, and the loperamide and the constipating diet slow down the colon to avoid “accidents” (passing stool in the underwear) in between enemas (WMV 16256 kb)

Animation 20.4

Animation showing the disimpaction process (WMV 37952 kb)


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Alberto Peña
    • 1
  • Andrea Bischoff
    • 1
  1. 1.Pediatric SurgeryColorectal Center for Children Cincinnati Children’s HospitalCincinnatiUSA

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