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

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

Considerations for Promoting Independence

It is important that independence in activities of daily living to the best of the child’s ability be an expectation. Promoting independence starts at an early age.

Create a daily bowel management routine at the same time each day.
Include the child in:

  • Gathering the supplies
  • Turning on the water and testing the temperature
  • Filling the irrigation bag
  • Controlling the fluid administration
  • Experimenting with proper placement of the enema

Over time the child can take on more responsibility as they are successful with each stage of the process.

It can be challenging for parents to allow their children to make mistakes, but it creates an opportunity for growth. Complete independence in self-management is reliant upon:

  • Adequate cognition (neuropsychology evaluation)
  • Balance (physical/occupational therapy evaluation [PT/OT] evaluation)
  • Range of motion (PT/OT evaluation)
  • Dexterity (PT/OT evaluation)
  • Adaptive or special equipment

Patients who are independent in self-management have a better quality of life and are able to attend school, social functions and work without the need for assistance in toileting.

Bowel Management Program and Escalation Plan