Bowel Management Program

Effective Therapeutic Strategy

The Bowel Management Program at Mass General for Children's Pediatric Neurogastroenterology and Motility Program is an intensive outpatient program for pediatric patients who have difficulty controlling their bowel movements. Your child is initially evaluated by our multidisciplinary team who personalizes the program to each individual to maximize effective outcomes. 

Our goal is to provide a therapeutic strategy personally tailored to each patient to effectively resolve your child's underlying symptoms. The Bowel Management Program is designed to help pediatric patients with a wide variety of diagnoses including:

• Hirschsprung Disease
• Anorectal Malformations
• Idiopathic Constipation
• Fecal Incontinence
• Chronic intestinal pseudo-obstruction
• Neurogenic Bowel (due to spina bifida, tethered cord)
• Other disorders of intestinal motility

The Bowel Management Program starts with an intense three day clean out regimen followed by a proactive management period with the goal of cleaning out the colon and resolving symptoms of constipation and fecal incontinence.

• Get the Colon Clean: Your child will be seen in the Pediatric Neurogastroenterology and Motility Program where a brief outline of the program will be explained to you. You will then be evaluated by our pediatric experts to decide the appropriate medications to use for your child’s management via clinical history and abdominal radiograph. The treatment plan will then be thoroughly explained and initiated.
• Follow up Treatment: Based on your child’s clinical history and radiograph results, an aggressive clean out regimen will be recommended from the first day to the third day of treatment. Effectiveness of the clean out will be identified through the use of an abdominal radiograph on day three.
• Keep the Colon Clean: Once the clean out of the colon is confirmed, your child will be in contact with a nurse who will guide your child’s management every two days based on clinical symptoms and weekly with abdominal radiographs. We will not stop our aggressive management until your child is effectively cleaned out with resolution of his or her symptoms.

Our Multidisciplinary Team

The Bowel Management Program is offered through the Pediatric Neurogastroenterology and Motility Program at MGfC. Each child will be evaluated and cared for by a team of experts, including pediatric surgeons, gastroenterologists, nutritionists, psychologists and nurses. Child psychiatrists, child life specialists and social workers are also readily available to assist in the care of these young patients.

• 

  Claire Zar-Kessler, MD

  • Co-Director, Pediatric Neurogastroenterology and Motility Program
  • Instructor, Harvard Medical School
• 

  Allan M. Goldstein, MD

  • Chief, Pediatric Surgery
  • Co-Director, Pediatric Neurogastroenterology and Motility Program
• 

  Janet Brideau, CPNP

  • Pediatric Gastroenterology and Nutrition Program 
  • Pediatric Neurogastroenterology and Motility Program
• 

  Daniel P. Doody, MD

  • Director, Surgical Education, Pediatric Surgery
  • Associate Program Director, MGH Surgical Residency Program
• 

  Gail Monahan

  • Administrative Coordinator