Neurogenic Bowel Management, Spina Bifida — Escalation Plan — Clinical Pathway: Outpatient Specialty Care

Neurogenic Bowel Management, Spina Bifida Clinical Pathway — Outpatient Specialty Care

Bowel Management and Escalation Plan

Monitoring the Response to Therapy
  • Following the initiation of therapy:
    • Ensure adherence to management
    • Adequate fiber
    • Adequate fluids
  • Review Stool Diary – Download Stool Diary 
Escalation of Therapy
  • When current management plan is successful
  • Consider modification only after consultation with spina bifida specialist.
  • Infants/Toddlers
    With each escalation allow 2 weeks to reach the goal of Bristol stool scale: 3-6.
  • Children/Adolescents
    With each escalation allow 1-3 months to reach the goal of < 1 accident/month, clean for 24 hrs.
  • Review bowel-management plan.
  • Emphasize importance of program.
  • Explain the importance of social continence and future impacts on confidence, relationships, education and employment opportunities.