Pediatric Colorectal Center

The Pediatric Colorectal Center (PCC) at Shriners Hospitals for Children — Northern California is a California Children’s Services (CCS) designated Special Care Center (SCC). As the only CCS Special Care Center for pediatric colorectal care in California, families throughout the state and country travel to Sacramento for comprehensive care. The PCC’s multidisciplinary approach brings specialists together to evaluate, diagnose, and solve colorectal health issues, from bowel management and motility problems to complex conditions such as Hirschsprung disease and anorectal disorders. The PCC offers long-term care for patients with congenital and idiopathic conditions with the goal of helping them to enjoy life with the fewest limitations possible.

Our noted team of pediatric surgeons understand the physical and emotional impacts of colon and rectal diseases. They lead a multidisciplinary team of professionals that manage the entire spectrum of care for kids of all ages – from infants to adolescents. Whether it be complex surgery, medical management or psychosocial support, our team addresses the individual needs of each patient. In all cases, the goal is to put patients on the path to independence by freeing them from the social stigma that may leave them feeling ashamed, depressed and alone

Bowel Management Program

Our Bowel Management Program is a one-week outpatient program for children who are unable to anticipate or control their bowel activity. After children participate in this intensive program, many of them are in normal underwear by the end of the week! By maintaining bowel management after the program ends, these patients can avoid bowel accidents, bed-wetting  permanent colostomy and dependence on diapers. The improvement in self-esteem and quality of life is often remarkable. This program is designed primarily for children age three-years-old and up.

At Shriners Hospital for Children Northern California, we understand that each child is unique and different. Together, we work with patients and families to create the best possible outcome. The goal of our program is to have every child be clean and in underwear. Learn more.

Patient Evaluation

Patients are seen in our Sacramento hospital clinic where the Pediatric Surgery team evaluates each patient and develops a treatment plan based on the individual needs of each child. At Shriners Hospitals for Children – Northern California, care is delivered in a hospital designed specifically to serve the medical and emotional needs of children and their families.

Why our team is different

Pediatric specialists at the Shriners Hospitals for Children — Northern California Pediatric Colorectal Center (PCC) care for a high volume of patients with colorectal health issues and rare colorectal conditions. The PCC participates in key consortiums, learning groups and research studies. Through collaboration with experts at other institutions, staff have developed and shared greater understanding of conditions and treatments to improve outcomes for children with colorectal disorders.

The PCC is an active member of the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC), an international group dedicated to furthering research on anorectal malformations, Hirschsprung disease, and other colorectal and pelvic disorders. The PCPLC includes clinical centers and a central data coordinating center, where a detailed registry of patients provides infrastructure for conducting focused studies. The consortium aims to perform multi-center prospective clinical trials, translate findings in practice, disseminate information and findings to providers, and offer training and career development opportunities.

Our team includes a multidisciplinary approach to care. When your child is seen in our Colorectal and Bowel Management Program, they have the input of social workers, child life specialists, nurses, dieticians, and physicians. We run a weekly multidisciplinary meeting discussing all of the upcoming patients to make sure that each child receives the input of each of our team members, even if you don’t meet one-on-one with each of these different specialists.

The key to success is dedication, timing and teamwork between the patient, families and medical team. We tailor each child’s regimen to their specific needs. Each child’s outcome will depend, in part, on the severity of their condition.

Conditions We Treat

• Anorectal malformations (imperforate anus)
• Bladder extrophy
• Caudal regression syndrome/sacral agenesis
• Chronic constipation
• Cloaca/cloacal anomaly
• Cloacal extrophy
• Encopresis
• Fecal incontinence
• Hirschsprung disease
• Idiopathic constipation
• Megacolon
• Neurogenic bladder
• Neurogenic bowel
• Pseudo-obstruction
• Rectal prolapse
• Rectal trauma

What is the Bowel Management Program?

Our program relies on methods shown to achieve results. We carefully adapt these methods to find the right balance for your child. We want you and your child to leave with a clear plan that you can use at home – and that may change your child’s daily life for the better. Learn more.

How will the Bowel Management Program help?

Trouble with bowel control (fecal incontinence) can lead to struggles at home, in school, in friendships, with emotions, behavior and mental health. Many incontinent children can be more active, social, happy and independent if they have a plan for bowel management that works for them. Our program is designed with YOU in mind. Learn more.

Outpatient

• At the initiation of our program, families meet in a group setting led by the Nurse Case Manager, along with a registered dietician and child life specialist. During this educational visit, the patient and their parent will receive information on the program, the work-up for constipation, dietary changes to improve constipation, and how to help the child cope with their diagnosis.
• This unique outpatient program is designed for children with constipation
  who cannot anticipate or control their bowel activity. Primarily for children
  age three and older, the week-long program enables most patients to avoid
  accidents, bedwetting, colostomy and dependence on diapers. Families
  are provided with clear plans to continue progress at home and access the
  resources available at the Pediatric Colorectal Center (PCC).
• Further visits are conducted one-on-one with a medical provider within our team.

Inpatient

• Patients with severe constipation or bowel control issues who have not
  achieved success from outpatient care often benefit from an inpatient
  program. A combination of medication, enemas, diagnostic testing, support
  and education are tailored to the needs of each patient. Families are given a
  clear plan for home care that includes dietary recommendations and return for
  follow-up appointments with the PCC team.
• After the hospitalization, the child is discharged with a clear treatment plan in place. Further follow-up appointments are conducted one-on-one with a medical provider from our team.

Meet the Team

Members of our team will work with you and your child on bowel management. Providers in the Bowel Management Treatment Program include:

Shinjiro Hirose, M.D.
Director of Pediatric Surgery

Payam Saadai, M.D.
Director of the Pediatric Colorectal Center

Maheen Hassan, M.D.
Director of GI Motility

Erin Brown, M.D.
Pediatric Surgeon

Arthur de Lorimier, M.D.
Pediatric Gastroenterologist

Jonathan Kohler, M.D.
Pediatric Surgeon

Minna Wieck, M.D.
Pediatric Surgeon

Eric Kurzrock, M.D.
Pediatric Urology

Jennifer Yang, M.D.
Pediatric Surgeon

Jennifer Miranda
Nurse Practitioner

Kat Swartz
Nurse Practitioner

Carolyn Wilson
RN Care Manager

Annabell Toll
Registered Dietician

Kat Davis
Outpatient Child Life Specialist and owner of Yogo

Yogo
Therapy and Support Dog

Sarah Ferrin
Inpatient Child Life Specialist

Courtney Krakie
Licensed Clinical Social Worker

Aime Andrade
Medical Assistant and patient scheduler

These team members have special expertise in treating children’s pelvic conditions and making bowel management plans with families. When you come to Shriners Hospitals for Children – Northern California, you get their combined knowledge and experience. They work with each other and with you to create a plan that meets your child’s needs.

To find out about joining the program, talk with your child’s doctor about a referral, or call (916) 453-2191. Before your child enters the program, the team does a full evaluation to understand your child’s condition and determine whether they might benefit from the program.