Cecostomy Web site

Cecostomy Web site | Pre-Operation | Cecostomy Procedures | Post Operation | Antegrade Enema | Increasing Fiber and Water | Other Antegrade Enema Solutions | Contact Information | Top 10 Reasons To Get a Cecostomy | Cecostomy Guest Book and Message Board

A.H. Balcom, MD
C.T. Durkee, MD
H.O. Mesrobian, MD
Welcome to the Cecostomy Web site
This Web site was designed to give the visitor a better understanding of what a cecostomy is, the steps in a cecostomy surgery and how to maintain a cecostomy. Other topics include: how the digestive system works, how to give an antegrade enema, the difference between a retrograde enema and an antegrade enema, and the importance of fiber and water.

What is a Cecostomy?
This procedure was first developed by Dr. Malone in England. A cecostomy is a procedure that creates an opening through which an antegrade enema can be given. The opening is placed in the cecum. This is part of the large intestines found next to the small intestines. An antegrade enema is used to empty the entire colon from the top portion of the large intestine down to the rectum. When an enema is given every other day, most bowel accidents can be avoided.

What is the purpose of a cecostomy?
The usual methods for giving an enema (retrograde) may not be effective since the enema solution may leak out as quickly as it runs in. An antegrade enema empties the entire colon from the top portion of the bowel down to the rectum. Antegrade enemas are often used for children with spina bifida and have recently begun to be used for the treatment of children with neurogenic bowels.

What is the normal function of the digestive system?
  1. Digestion of food begins in the mouth.
  2. After the food is chewed and swallowed, it moves into the esophagus. The esophagus is a hollow tube of muscle. It connects the mouth to the stomach.
  3. The stomach grinds and crushes the food into small pieces. Digestive juices from the stomach mix with the food. The stomach stores the food for a short time before it is pushed into the small intestine.
  4. The small intestine is a hollow tube of muscle where food is further digested until it is liquid. This liquid then passes into the bowel.
  5. Here, the body absorbs extra water from the liquid. The leftover waste product then becomes stool. It takes 1 to 2 days for stool to pass through the large intestine.
  6. The stool then enters the rectum. The rectum is a storage area for stool, just like the bladder stores urine. When the rectum becomes full of stool, nerves send a signal to the brain to say it is time to have a bowel movement.
  7. When it is time to empty the stool out of the rectum, the external anal sphincter (a muscle at the end of the anal canal) relaxes so the stool can pass out of the body.

Spina Bifida Association of Wisconsin

How is the digestive system different in individuals with spina bifida?
Several things may be different in the digestive systems of individuals with spina bifida and neurogenic bowels.

The food may pass through the digestive system more slowly than normal. The more time food remains in the large intestine, the more water it will absorb and the firmer and harder the stool becomes.

The nerves in the rectum may not be able to tell the brain when stool is present. Therefore, the child has no awareness of the need to have a bowel movement.