Bowel Management Boot Camp: Frequently Asked Questions

Who is the bowel management program for?

The bowel management program is for children unable to control their bowel movements or patterns, despite prior attempts. This may include children with: 

• Anorectal malformation

• Cloaca/cloacal exstrophy

• Chronic constipation

• Hirschsprung disease

• Spinal differences

• Neurogenic bowel  

What is the goal of Bowel Management Boot Camp?   

The goal by the end of the week is for your child to stool 1-2 times daily without stool accidents, leaking, or streaking in between. This is achieved through a medication, enema, or flush program. Our team will determine which program is best for your child.   

Should we have our child perform a clean out before the first day of Bowel Management Boot Camp?

No, you do not need to do a clean out beforehand. Our team will review your child’s imaging during the first Bowel Management Boot Camp appointment. If a clean out is needed, our team will discuss recommended treatment with you and your family.  

How often is the program held?  

Bowel Management Boot Camp is held monthly, typically starting on the first Friday of the month. Please inquire about future availability.

What is your typical bowel management week schedule?

Children’s Mercy offers a one-week program, Friday through Friday. The day prior to boot camp begins with a virtual presentation from our team and optional virtual meeting with our providers to answer family specific questions. Initial appointments will be held on Friday with a follow-up visit scheduled for the following Friday. In between appointments, patients will have daily visits to radiology and remain in close communication with the team to adjust their bowel management.
 

Who leads the bowel management team?

Dr. Lim-Beutel and Dr. Rentea lead our team of bowel management trained nurse practitioners, nurses, and support staff. Each day, our team will review your child’s imaging and report to determine the best course of action. Our nurses will communicate these findings and recommendations to you daily. 

Do we have to stay in Kansas City for the full week of Boot Camp?

Patients and families should expect to come to Children’s Mercy Adele Hall Campus for their first Bowel Management Boot Camp Appointment.  You will meet the team and obtain imaging, as needed. For patients living anywhere in Kansas or Missouri, the rest of the Bowel Management Boot Camp can be done virtually with imaging being completed at a facility near the patient’s home.

For families who reside outside of the Kansas or Missouri area and need help with lodging, we will connect you with our local Ronald McDonald House to make a housing request.

What support is provided for patients and their families who are traveling from out of town? 

We  will talk each day with our Boot Camp families by phone or the patient portal. Before your first day of boot camp, be sure you are signed up for the MyChildrensMercy patient portal. You can contact us at any time you have a question or concern about your child.

Will insurance cover the cost of Bowel Management Boot Camp? 

Boot camp is billed as 2 clinic visits and 6 single-view x-rays. The Boot Camp visits should be covered if your insurance includes Children’s Mercy as an in-network provider. We always encourage families to contact their insurance carrier to be sure of coverage. If you have more questions about the costs of care, contact our Financial Clearance team at (816) 302-1650.  

How are patients followed after the program is over?

On the last day of Bowel Management Boot Camp, patients and families will have a clinic visit with one of our Boot Camp providers to talk about next steps in care and follow-up. You can call our care team at (816) 234-3441 or message us on the patient portal.    

Does the program offer Transition of Care for adolescent and adult patients?

We know that it is important to have multidisciplinary care for patients with a history of complex colorectal and pelvic reconstruction. We work with patients and families to develop an individualized transition plan based on each patient’s developmental level. We work to transition patients to adult providers before the age of 22. 

What data demonstrates that your program produces positive outcomes for bowel management patients?

We follow the most current evidence-based care protocols to treat all types of colorectal diagnoses. We are a participant center of the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) to ensure ongoing evaluation and improvement of evidence-based practice.  

Studies show that bowel management with consistent follow-up is successful to help patients be clean and continent and increase patient and family quality of life.

Baxter et al. J Pediatr Surg. 2020 Dec: 55 (12):2752-57. Lim I, et al. J Pediatr Surg. 2021