Cone Enema Bowel Management Program for Spina Bifida Patients

When a child with spina bifida turns 3 years old, specialists in CHOP’s Spina Bifida Clinic usually recommend that a cone enema bowel management plan should be added to their medical care.

The short- and long-term goals of the cone enema are to:

• Maintain cleanliness in between toileting times
• Avoid daytime bowel accidents
• Prevent constipation 
• Achieve independence relevant for each child

A cone enema bowel program can help:

• Improve a child’s self-esteem and social interaction
• Maintain optimal bladder and kidney function
• Maintain skin integrity related to diaper rash and sores

A nurse in the Spina Bifida Clinic will provide the appropriate educational material for parents and children to read before they complete a video teaching session. The prerequisite for a cone enema bowel program is the child’s ability to independently sit on the toilet for a half hour to an hour. 

We schedule a telemedicine visit with a nurse and a doctor. They walk through the process of gathering the appropriate supplies to administer the enema. The doctor and nurse then teach the parent or caregiver how to administer the cone enema, and then observe the parent or caregiver administering the cone enema. This teaching session provides an opportunity to troubleshoot any potential problems that may occur during administration, address any concerns parents may have, or answer any questions.

The Spina Bifida Clinic conducts cone enema training video visits for our clients every second and fourth Tuesday of each month. One week after the training session, the nurse will follow up with parents/caregivers to see how their child is doing with the cone enema.

If you are interested in learning more about a cone enema bowel program and you want to schedule training, please call 267-426-6852.