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Bowel accidents can be upsetting for both children and their parents. These can occur when a child becomes constipated and doesn't have regular bowel movements, or when they lose the ability to control their bowels when it leaves their body.

Both forms of accidents are linked to fecal incontinence or soiling. When these instances become repetitive, intervention is necessary to help regulate the child’s bowel activity.

A bowel management plan is a customized plan designed for children who suffer from any form of fecal incontinence. The plan includes multiple components to ensure that your child has regular bowel movements and can keep their colon clean.

There are a few different reasons why a child might suffer from fecal incontinence. Each case is unique and it can occur at various stages of their childhood.

For instance, a child might develop this issue for a short period of time as they transition from formula to eating solid foods. Or, it can occur as a result of a specific medical condition, such as Hirschsprung disease or an anorectal malformation.

Both conditions can leave children with long-term bowel problems, including:

A bowel management program uses different techniques to help a child learn how to slow down and better control their colon. The methods used can include:

The goal of the program is to help children have at least one bowel movement each day. They should also be able to remain clean and dry in between each bowel movement.

All types of children who suffer from diarrhea, constipation, or fecal incontinence can benefit from a customized bowel management program. If a child does not have a regular bowel movement every day, then this plan and program may be beneficial.

However, children who have been diagnosed with the following conditions are more likely to require this intervention than others:

If your child is having difficulty with constipation or stool soiling, then their doctor may recommend that they start following a bowel management plan.

Before diving into the specific steps that can help regulate your child’s bowel activity, the doctor will first take the time to thoroughly analyze their past medical history, as well as their surgical history.

This gives them the opportunity to understand if they’ve experienced any of the conditions, diseases, or surgeries that may create or exacerbate instances of fecal incontinence.

At this time, the doctor will also speak with you to understand what steps you’ve taken to date to help your child cope with this problem. This may include changing their diet, giving medications, administering an enema, or any other type of action meant to instigate stool activity.

To make sure this first visit is as detailed and accurate as possible, it helps to bring documents that detail the history of your child’s condition. This includes:

• A list of medications your child has taken
• A list of all of the surgeries and tests that your child has undergone
• Documents from the hospital where your child was born or treated

Hospital documents can include operative reports, x-ray reports, and discharge summaries, among other notes. You may have to request a copy of these documents from the hospital’s Medical Records department.

Depending on what the doctor learns at your child’s health assessment, they may order tests or procedures to uncover more information about their condition. For instance, they may perform an x-ray of their abdomen to see the condition of their intestines more clearly.

Your child’s bowel management plan will include daily steps that they can take to encourage regular bowel movements. These may include dietary changes that add more fiber and nutrients to your child’s diet, with an uptick in foods such as:

While these changes may affect the whole family, they are often necessary to “reset” the child’s bowel activity and get it back on track. Your doctor will also share certain foods that can exacerbate symptoms of constipation, diarrhea, and fecal incontinence, so you know to avoid them.

In addition to changing their diet, the plan will also include guidelines on how to increase the amount of water that your child intakes every day. An adequate supply of water can keep their stools soft and make their bowel movements more comfortable.

Sometimes, doctors will recommend certain medications as part of a child’s bowel management plan. When this is the case, their plan will clearly list all of the medications, along with the exact doses required and the times of day to administer them.

In addition to (or in lieu of) medication, your child’s doctor may also recommend the use of enemas. If these are needed, the plan will include detailed instructions on how to give them to your child.

Once you have received the plan, you can begin putting it into action with your child at home. If the steps are successful, they should begin having a bowel movement every day.

If this does not occur, you can contact your child’s doctor to follow up. You should also contact the doctor immediately if your child experiences any adverse reactions as a result of following the plan, such as:

• Vomiting (especially yellow or green)
• Swollen abdomen

In some cases, children might develop more minor symptoms as a result of the plan. These typically aren’t as severe in nature, but still require a call to your child’s doctor. They include:

The doctor may schedule a follow-up visit to further investigate and address these issues.

When this is the case, parents are often concerned that the child will become addicted to certain parts of the plan, such as the use of enemas or laxatives. This is not an issue.

Rather, these treatments are often necessary to help your child have a daily bowel movement and remain clean. Before stopping any treatments or medications, be sure to speak with your child’s doctor.

Many of the steps included in a bowel management plan, such as eating a healthy, fiber-rich diet and prioritizing fluid intake, will help your child’s overall growth and development. Talk to your child about implementing the plan and making the steps part of their daily routine, and stay in contact with their medical team to monitor their progress.

With the right plan in place, your child can stay regular and avoid accidents. This can help them succeed in many areas of life, from socializing and making friends to paying attention in school. Over time, it can lay the foundation for a healthy, happy future and optimized quality of life.