Fecal incontinence remains a detriment to improved quality of life in many patients
with spina bifida. Previous methods of conservative management frequently prove to
be inadequate, causing many patients to withdraw from the social mainstream. Recent
descriptions of procedures to provide access to the proximal colon for antegrade colonic
enemas (ACE procedure) have provided a new approach to managing fecal incontinence.
We report here our experience with these procedures in 43 patients with spina bifida.
The background, techniques and outcomes of these procedures are discussed and a plea
is made to consider this approach in all patients who are hampered in their social
or vocational progress because of neurogenic anorectal dysfunction.
Spina bifida - Fecal incontinence - Appendicostomy - Antegrade colonic enema (ACE)
