Program Information

What is Bowel Management?

The Colorectal Program at Lucile Packard Children’s Hospital Stanford is an outpatient program for children who have a history of anorectal malformations (ARM), Hirschsprung’s disease, cloacal exstrophy, and neurogenic bowel that suffer from constipation and/or fecal incontinence. Bowel management involves interventions to provide such children the ability to establish a scheduled colon evacuation of stool to prevent fecal accidents.

The program is designed primarily for children who are of toilet trainable age and suffer from fecal incontinence

  • Hirschsprung's Disease
  • Imperforate Anus
  • Neurogenic Bowel
  • Cloacal Exstrophy


The program is designed as a partnership between the family and provider team to best capture the child's stooling pattern and then create an individualized regimen specific to their needs. This may include a variety of imaging or tests, oral laxatives, enemas, dietary education, or referrals to other subspecialty services. The long-term success is confirmed by each family’s satisfaction with and willingness to continue the recommended regimen.

Prior to the Clinic Visit

Before coming to your child's Colorectal Clinic appointment, please be sure to complete the 1-week bowel record for your child and bring it with you. Completing this form will help and enable us to determine the best bowel regimen for your child. 


Laxative and Enema Trials

The trial begins with a clinic visit and includes bowel clean outs, serial x-rays, and adjustments to laxative or enema regimens. You and your child will meet with our colorectal surgeons and advanced practice providers (NP/PA) who will work with you to establish an individualized plan of care. The goal of these trials is to achieve days free of fecal accidents. Trials can be conducted on an outpatient or inpatient basis based on patient need. 

Most of the children who are in this program will need to maintain a bowel management regimen for their entire lives. We are committed to helping them be successful while providing individuaized care. 

Contact Information

For more information about Lucile Packard Children’s Hospital Stanford Colorectal Program, call our office at (650) 723-6439.


The Division of Pediatric General Surgery offers an extensive online resource of general health information. Please do not substitute information on this website for professional advice, a diagnosis of your condition, or a recommendation about the course of treatment for your particular circumstances. This information is not intended to be, and should not be used as, a substitute for medical treatment by a health care professional. You should never disregard or delay seeking medical advice because of what you have read on this website.

Enema Education Materials

Enema Demonstration

Peristeen safety

Demostración de enema

Peristeen de forma segura

Our Team

Family Testimonials

Mother of 6 year old with imperforate anus

"We are so fortunate to have the best care for our son at LPCH. The bowel management team has helped us to feel that we are not alone with this. We have had a great support from all his doctors. They have guided us with the best studies and management for our son's bowel movements. My son has received lots of love, and different alternatives to help him. A special thanks to Claire who, no matter what, is always there to help us. His doctors are angels on earth to always be thankful!!"

Mother of 9 year old with Hirschsprung's disease

“I want to thank the management program for helping me to get ahead with my son and thank God that he put these people towards my way to be able to help my son. The surgeon,  Dr. Mueller and nurse practitioner, Claire Abrajano, I thank you very much.  And to all the people I recommend this program of bowl management for their children.  They are very professional, without them I do not know what I would do with my son and thanks to God I was touched by people like them during this time. I want to recommend this program and this group of doctors for their children who need bowel management. And that God keep blessing them so they can help many children like my son to get ahead.”

Mother of 6 year old with imperforate anus

“The bowel management program has always gone above and beyond when it comes to helping my son and getting his needs met. The group has always been great at making my son feel comfortable as well as making sure my husband and I are comfortable with any treatment plan we try.”

Clinic Location

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Bowel Management Clinic

730 Welch Road, 2nd Floor
Palo Alto, CA 94304
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Stanford Clinic:

Phone: (650) 723-6439

Fax: (650) 725-5577