Children often benefit from a combination of laxatives. Oral laxative medication - There is a wide range of oral laxative medications available, some of which help to soften stool and others which help the bowel to push stool along.Longer term ineffectiveness: Findings from longer term research studies are informing us that, even when children have initially had a good response to their ACE and achieved cleanliness, many will, over time, find their washouts become gradually less effective with exacerbation of constipation and / or soiling again.Īlternative therapies for the management of constipation and soiling can be grouped as follows:.Ongoing pain during washouts despite dose and speed of administration of washouts being adjusted.Symptoms of an adhesion obstruction include cramping abdominal pain and green (bile) vomit. It is a small but lifelong risk which may result in an obstruction (blockage) of the bowel. Adhesions (rare): this is scar tissue formation which can occur after any abdominal operation.If a false passage is created more surgery will be required and more time with an indwelling catheter in place will be needed. Creation of a false passage: this means that a passage outside the channel is formed, usually as a result of tract stenosis or difficulty with catheterisation.Tract stenosis: this means that the ACE channel becomes narrow and so the intermittent catheter becomes difficult, or even impossible, to insert.irrigation fluid inserted via the ACE is not evacuated.Some children find that the ACE irrigations do not work for them, for example, due to:.In severe cases children can feel nauseous, vomit or faint.Ĭomplications / problems in the longer term: The bowel preparation plan is designed to minimise this pain but children may still experience sensations they regard as unpleasant or painful as they get used to the feeling of the washouts. Painful washouts caused by bowel spasm as washout fluid is administered.Migration of the catheter further into the bowel.The catheter placed at the time of surgery may fall out, possibly requiring a further operation to replace it or re-fashion the channel.Leakage of faeces around the ACE catheter.If the blood supply to the bowel used to form the ACE channel is impaired the tissue can die, requiring further surgery to re-fashion it.Ĭomplications / problems whilst indwelling ACE catheters are in place are not uncommon and include:.Risks, complications and problems may occur at the time of surgery (rare), in the initial weeks after surgery when the indwelling catheter is in place and in the long term (more common).Ĭomplications at the time of, and immediately after, surgery are rare but include:
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