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What is Bowel Management?

By Marco Sumayao
Updated May 17, 2024
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Bowel management is a technique applied to patients in an effort to manage the symptoms of fecal incontinence. Through a combination of different medications and procedures, doctors can determine a routine that allows patients to minimize the effect fecal incontinence has on their daily lives. The treatment is especially significant in developing a sense of independence among children with poor bowel control. Although bowel management does not effectively cure incontinence, it can significantly improve the quality of life for the patient.

The procedure often begins by cleansing the patient's colon at the start of each day. The cleanse usually involves an enema at the beginning, followed by laxative use. This helps minimize the feces stored inside the patient's gastrointestinal tract, effectively reducing the risk of untimely defecation. This routine can be supplemented by a diet designed to minimize the impact food has on the patient's bowel movements.

During the first few weeks of bowel management, patients undergo constant medical supervision. Doctors need to monitor the severity of the patient's incontinence, as well as the effectiveness of both treatment and medication. Along with carefully taking notes on the amount of feces expelled at the start of each day, doctors can examine x-ray images of the patient's colon to ascertain whether or not any waste remains. The routine and medication are changed up on a regular basis to determine the most effective options. Once a bowel management routine is finalized, doctors instruct the patient on self-administration methods.

Self-administration of bowel management techniques is an important aspect of the treatment as it eliminates the patient's dependence on doctors or other individuals. It allows patients to go about their daily lives relatively unburdened by their incontinence; they can participate in activities that would otherwise be impossible due to the risk of sudden and spastic bowel movements. This aspect of the treatment is the main factor in improving the patient's quality of life.

Bowel management cannot be considered a cure for fecal incontinence, as it does not eliminate or treat the disorder's causes. Fecal incontinence is most often caused by defects in the muscles and nerves that control bowel movement. These issues are often difficult, if not impossible, to treat, making bowel management one of the few viable options for alleviating the symptoms of fecal incontinence. In certain cases, however, patients can develop pseudoincontinence as a result of constipation. This form of incontinence can easily be treated through laxatives, rendering bowel management unnecessary.

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