Cecostomy is surgery to clear a child's bowels of feces when other treatment has not worked. It is used for children with fecal incontinence caused by major health problems. Fecal incontinence means your child can't control their bowels. Symptoms can range from having severe constipation to having a bowel movement at an unexpected or embarrassing time.

Cecostomy is different from an enema that is used to ease constipation. An enema is given directly through the rectum to help free the feces. In a cecostomy, the doctor puts a tube (catheter) through the skin of the abdomen (belly area) into the first part of the large intestine (cecum). It is in the lower right abdomen. The doctor injects liquid medicine into the cecum through this tube. The medicine helps the feces move out of the body through the rectum.

Your child may need a cecostomy if they have fecal incontinence and other treatments have not worked. But most children with this health problem will have success with other treatments.

Or your child may need the procedure if:

• Their anus isn't letting feces pass as it should (imperforate anus).
• They have spinal problems, such as spina bifida.
• They have a combination of the above two health problems.
• They have other muscular problems.

Most children don't have any problems with the procedure. But it does have some risks. These are:

• The tube (catheter) gets displaced.
• An infection in the abdomen (peritonitis) caused by misplacing the catheter.
• Mechanical failure of the tube.
• Growth of tissue at the tube site.
• Bleeding and irritation at the tube site.
• An infection around the site where the tube was inserted.

Getting ready for the procedure includes these steps:

• Before the tube can be put in, your child may need a bowel prep to clean the colon.
• For the bowel prep, your child will have to be on a clear-fluid diet for 2 days before the cecostomy.
• The night before the procedure, your child will likely need to drink a laxative solution. It cleans out the bowels.
• On the day of the procedure, your child will have an abdominal X-ray to make sure the bowel is free of stool.

Your child will need to stay in the hospital for the procedure to insert the cecostomy tube. The stay often lasts 1 to 2 days. Most of the time, the procedure will go as follows:

• Your child will get medicine through an I.V. (intravenous) line that helps them relax during the procedure. Your child may be put to sleep with general anesthesia.
• A doctor usually inflates the colon with air until the cecum is expanded.
• The doctor puts surgical tools through small cuts (incisions) in the skin and into the cecum. They attach the bowel to the abdominal wall with stitches, sutures, or fasteners.
• The doctor puts a special hollow needle into the cecum.
• The doctor threads the catheter through this needle and into the cecum.

This procedure can also be done with a laparoscope. With this method, the doctor puts a laparoscope into a small incision in the belly button.

The process outlined above is what is done to insert the cecostomy tube. Then, based on your child's needs, the cecostomy itself will be done occasionally to relieve their bowels.

After the cecostomy tube has been put in, your child will stay in the hospital until the next day for observation. This will help lower the risk for complications.

Your child may also need a contrast study. This test makes sure that the catheter is placed correctly. For this test, the doctor injects contrast dye through the tube and into the cecum. Then the doctor uses an X-ray to look at the dye to make sure that it travels into the cecum.

Putting the cecostomy tube in place is just the first step in easing fecal incontinence. After about a week, you'll give your child an enema through the cecostomy tube at home, with guidance from your child's doctor. This process will involve putting liquid into the cecostomy tube. This liquid will pass into the cecum to encourage a bowel movement. Your child's doctor will tell you how often this will need to be done.

Tell your child's doctor if your child has:

• A noticeable skin infection at the catheter (tube) site.
• Bleeding or swelling at the site.
• Pus leaking from the site.
• A dislodged tube, or if their tube moves.
• Abdominal (belly) pain.
• A fever.

Your child will likely need to have the catheter removed and replaced from time to time. It will have to be done for hygiene reasons and to lower the risk for complications.

Before you agree to the test or procedure for your child, make sure you know:

• The name of the test or procedure.
• The reason your child is having the test or procedure.
• What results to expect and what they mean.
• The risks and benefits of the test or procedure.
• When and where your child is to have the test or procedure.
• Who will do the procedure and what that person's qualifications are.
• What would happen if your child did not have the test or procedure.
• Any alternative tests or procedures to think about.
• When and how you will get the results.
• Who to contact after the test or procedure if you have questions or your child has problems.
• How much you will have to pay for the test or procedure.