Postoperative anorectal continence evaluation program (PACE)
Hirschsprung disease and anorectal malformations each occur in approximately 1 per 5000 live births. Surgical intervention is required for both diagnoses but surgery alone is not a cure. After surgery, children with these conditions are at risk for developing problems with constipation (retention of stool), diarrhea and fecal incontinence (involuntary passage of stool).
The postoperative continence evaluation (PACE) program at Children's Memorial Hospital is designed to help children who have undergone surgical interventions for Hirschsprung disease and anorectal malformations achieve successful bowel management.
Program goals
The goal of the PACE program is to help each child achieve a normal lifestyle, avoiding constipation and fecal incontinence. Not surprisingly, these conditions negatively affect a child’s quality of life.
Due to the complexity and variety of anorectal malformations and Hirschsprung disease, treatment varies from patient to patient. There are many ways to manage these problems.
Management plan
Management options may include a combination of enemas, rectal irrigations, dietary modifications, laxatives, and other medications. Evaluation techniques include abdominal examinations, rectal examinations, abdominal X-rays, and anorectal manometry.
It is important to understand that evaluation techniques and management plans are individualized for each child. As the child grows and develops adjustments are required.
PACE staff
During your child's PACE office visit you and your child will be seen by a number of professionals with special interest and expertise in treating children with anorectal malformations and Hirschsprung disease.
Pediatric surgeon Mary Beth Madonna, MD, and gastroenterologist Miguel Saps, MD, will develop a bowel management plan that is specific for your child and your family.
Follow-up
Patients, parents and PACE staff professionals must work together to achieve the best outcomes. The number of visits and specific management options will depend on how your child is doing.
Close follow-up is important so that the conditions that lead to stool incontinence can be avoided.
Contact information
For more information, call 773.880.4422 and ask for one of the nurses listed here:
Cindy Kerr, MSN, CPNP
Maria Manuel-Rubio, MSN, CPNP
Kerri Baldwin MSN, CPNP
Additional resources you may find helpful