Bowel Management Boot Camp

The Children’s Mercy Bowel Management Boot Camp is an outpatient program in Kansas City, Missouri. It is a 7-day program for children who want to gain confidence with their bowel control. We create a special treatment plan for each child with stooling difficulties.

Specifically, we treat stooling issues for children diagnosed with: 

• Anorectal malformations (imperforate anus)
• Cloaca/cloacal exstrophy
• Chronic idiopathic constipation
• Hirschsprung’s disease
• Spinal differences (spina bifida, spinal trauma, sacral coccygeal teratoma)
• Neurogenic Bowel  

Types of treatment

During boot camp, the team uses a variety of therapies to help each child find their ideal bowel movement schedule. Our team will determine which treatment is best suited for your child. We have three treatment programs that we will adjust to fit your child’s needs. These include:

Medication program

This program involves taking medicine every day to create a bowel movement (pooping) pattern. It helps children whose colon and bowel work too fast or too slow. Our goal is for your child to have one to two purposeful bowel movements a day, with no accidents in between.

Enema program

An enema is a way to put fluid into the last part of the colon (rectum) to remove stool from the intestine once each day. A flexible catheter and fluid bag are used to give the enema. Our goal with this program is to empty the colon with the enema and be accident free between enemas. 

Appendicostomy (Malone, ACE, MACE)

An appendicostomy is a surgically created way to give a flush from the “top down,” or beginning part of the colon, instead of from the bottom (such as in an enema). 

Some children come to our bowel management camp after they have had an appendicostomy created. Other children wish to have an appendicostomy placed after they have established a working enema program. This may give the child more independence, since they can help give the enema/flush through their abdomen instead of from their bottom.

Bowel Management Boot Camp: What to Expect 

Your child may be asked to undergo special imaging (X-ray) called a contrast enema. This will allow our team to better understand your child’s colon anatomy.

The care team may also decide if your child would benefit from a special examination.  If so, this will be scheduled prior to boot camp. Please continue your child’s current bowel regimen prior to their first appointment.

Boot Camp Schedule 

A few days before Boot Camp, you will be sent a link to a short video made by our team.  This video gives detailed information about the Boot Camp week.  There is an optional virtual meeting with the providers to answer any family specific questions. 
Your child’s first appointment will be on Friday. Go to radiology for an X-ray before your child’s appointment. 
At your child’s appointment, we will: 

• Review imaging and test results.

• Discuss goals for the week.

• Confirm the treatment program.

• Give you supplies and prescriptions, as needed.

• Discuss additional supplies you may need to buy over the weekend.

Your child will have an abdominal X-ray each day (Monday through Thursday) after they have stooled.  This will show us how much stool is left in the colon.

You will also receive an e-mailed link to a daily survey to report your child’s progress.  The care team will review the information, along with the x-ray, each day.  Then we can adjust your child’s bowel management plan as needed. A team member will call or message you with the plan for the next day. The final boot camp day is Friday. This visit can be in-person or virtual.  At this appointment we will: 

• Review your child’s weekly progress.

• Determine a final care plan.

• Schedule follow-up appointments.