Malone et al described a procedure for pediatric patients with intractable fecal incontinence. Henrichon et al developed a scale for grading fecal incontinence at the stoma. The authors are from the University of California Davis Children's Hospital and Shriners Hospital for Children-Northern California.
Malone et al developed the Antegrade Continence Enema (MACE) procedure, which may be modified for the individual patient. The procedure creates a catheterizable conduit, often out of the appendix, which allows a tap water enema to be introduced into the cecum on a daily basis.
Fecal incontinence at the small stomal opening tends to be a minor problem for most patients.
Risk factors for incontinence at the stoma include:
(1) gastroenteritis
(2) fatty foods
Parameters for grading scale:
(1) drop of feces at stoma
(2) fecal spotting on clothes
Frequency of Fecal Drop or Spotting
Grade
none
0
<= 1 per month
1
2 to 4 times per month
2
>= 5 times per month
3
Recordkeeping would best be done with a daily diary.
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