Presenter Status
Resident/Ph.D/Post graduate (> 1 month of dedicated research time)
Abstract Type
Research
Primary Mentor
Rebecca M. Rentea, MD, MS
Start Date
12-5-2023 11:30 AM
End Date
12-5-2023 1:30 PM
Presentation Type
Poster-Restricted Access
Description
Background: The bowel management program (BMP) is a program that has been reported to be effective in managing patients with anorectal malformations (ARMs), Hirschsprung disease (HD), spinal anomalies, and functional constipation (FC), by decreasing the rate of ED visits and hospital admissions.
Objectives/Goal: We aim to report the recent updates on a bowel management program for patients with a colorectal diagnosis (ARM, HD, spinal anomaly, and FC) based on recent literature. The current review focuses on antegrade continence enemas (ACEs) as a treatment option for patients with constipation and/or soiling. Additionally, a review of the organizational aspects of a dedicated BMP, including the collaborative approach, importance of family education, telemedical technologies, and long-term outcomes of a BMP, was performed.
Methods/Design: A literature review utilizing the Medline/PubMed database focusing on the research studies published over the last 5 years was performed. Search keywords included: bowel management, antegrade continence enema, boot camps, outcomes, family education, collaborative approach, and telemedicine.
Results: The ACE procedure is performed for mechanical emptying of the colon when the channel can be created via an appendicostomy (Malone), neoappendicostomy (Neomalone), or cecostomy. The advantages of each technique remain controversial. The decision-making should be done to appreciate the urological needs for a simultaneous Mitrofanoff/Monti channel creation. Implementation of a multidisciplinary program involving physicians, nurses, advanced practice providers, coordinators, psychologists, and social workers leads to rapid center growth. Education of the families is crucial for postoperative outcomes, prevention, and early detection of complications, especially Hirschsprung-associated enterocolitis. Telemedicine can be proposed to patients with a defined anatomy and is associated with high parent satisfaction and decreased patient stress compared to in-person visits. The BMP was proven effective in all groups of colorectal patients at a 1- and 2-year follow-up, with social continence achieved in 70-72% and 78% of patients, respectively, and improved quality of life.
Conclusions: This review focuses on updates in the use of antegrade flushes for bowel management, organizational aspects, collaborative approach, telemedicine, family education, and one-year outcomes of the bowel management program.
MeSH Keywords
bowel management/enema/cecostomy/outcomes/education/collaboration/telemedicine
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Pediatric Bowel Management Options and Organizational Aspects
Background: The bowel management program (BMP) is a program that has been reported to be effective in managing patients with anorectal malformations (ARMs), Hirschsprung disease (HD), spinal anomalies, and functional constipation (FC), by decreasing the rate of ED visits and hospital admissions.
Objectives/Goal: We aim to report the recent updates on a bowel management program for patients with a colorectal diagnosis (ARM, HD, spinal anomaly, and FC) based on recent literature. The current review focuses on antegrade continence enemas (ACEs) as a treatment option for patients with constipation and/or soiling. Additionally, a review of the organizational aspects of a dedicated BMP, including the collaborative approach, importance of family education, telemedical technologies, and long-term outcomes of a BMP, was performed.
Methods/Design: A literature review utilizing the Medline/PubMed database focusing on the research studies published over the last 5 years was performed. Search keywords included: bowel management, antegrade continence enema, boot camps, outcomes, family education, collaborative approach, and telemedicine.
Results: The ACE procedure is performed for mechanical emptying of the colon when the channel can be created via an appendicostomy (Malone), neoappendicostomy (Neomalone), or cecostomy. The advantages of each technique remain controversial. The decision-making should be done to appreciate the urological needs for a simultaneous Mitrofanoff/Monti channel creation. Implementation of a multidisciplinary program involving physicians, nurses, advanced practice providers, coordinators, psychologists, and social workers leads to rapid center growth. Education of the families is crucial for postoperative outcomes, prevention, and early detection of complications, especially Hirschsprung-associated enterocolitis. Telemedicine can be proposed to patients with a defined anatomy and is associated with high parent satisfaction and decreased patient stress compared to in-person visits. The BMP was proven effective in all groups of colorectal patients at a 1- and 2-year follow-up, with social continence achieved in 70-72% and 78% of patients, respectively, and improved quality of life.
Conclusions: This review focuses on updates in the use of antegrade flushes for bowel management, organizational aspects, collaborative approach, telemedicine, family education, and one-year outcomes of the bowel management program.
