{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:40:15Z","timestamp":1791848415325,"version":"4.3.4"},"reference-count":100,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Patients with spinal abnormalities often struggle with fecal and\/or urinary incontinence (up to 87 and 92%, respectively) and require a collaborative approach to bowel management in conjunction. Methods: To define existing approaches and propose state-of-the-art bowel management, a literature search was performed using Medline\/PubMed, Google Scholar, Cochrane, and EMBASE databases and focusing on the manuscripts published July 2013 and July 2023. Results: Patients with spinal anomalies have impaired innervation of the rectum and anal canal, decreasing the success rate from laxatives and rectal enemas. Thus, transanal irrigations and antegrade flushes are widely utilized in this group of patients. Based on spinal MRI, the potential for bowel control in these children depends on age, type, and lesion level. On referral for bowel management, a contrast study is performed to assess colonic motility and evacuation of stool, followed by a series of abdominal X-rays to define colonic emptying and adjust the regimen. The options for management include laxatives, rectal enemas, transanal irrigations, antegrade flushes, and the creation of a stoma. Approximately 22\u201371% of patients achieve social continence dependent on the type and level of the lesion. Conclusion: Patients with spinal anomalies require a thorough assessment for continence potential and stool burden prior to initiation of bowel management. The optimal treatment option is defined according to the patient\u2019s age, anatomy, and mobility. The likelihood of independent bowel regimen administration should be discussed with the patients and their caregivers.<\/jats:p>","DOI":"10.3390\/children10091558","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T02:54:13Z","timestamp":1694746453000},"page":"1558","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["State of the Art Bowel Management for Pediatric Colorectal Problems: Spinal Anomalies"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0712-3508","authenticated-orcid":false,"given":"Elizaveta","family":"Bokova","sequence":"first","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ninad","family":"Prasade","sequence":"additional","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Children\u2019s Mercy Kansas City, Kansas City, MO 64108, USA"},{"name":"Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene Isabel P.","family":"Lim","sequence":"additional","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"},{"name":"Department of Surgery, University of Missouri-Kansas City, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Levitt","sequence":"additional","affiliation":[{"name":"Division of Colorectal and Pelvic Reconstruction, Children\u2019s National Medical Center, Washington, DC 20010, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8689-5989","authenticated-orcid":false,"given":"Rebecca M.","family":"Rentea","sequence":"additional","affiliation":[{"name":"Comprehensive Colorectal Center, Department of Surgery, Children\u2019s Mercy Hospital, Kansas City, MO 64108, USA"},{"name":"Department of Surgery, University of Missouri-Kansas City, Kansas City, MO 64108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1002\/bdra.20735","article-title":"National Birth Defects Prevention Network. 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