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CHOC Colorectal and Urogenital Center

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At CHOC, we know how hard it is for parents to see their child live with a complex colorectal condition. We know you want the best possible care for your child and to see them flourish. That’s why the CHOC Colorectal and Urogenital Center aims to help kids get back to being kids.

Children’s colorectal disorders require the care of several specialists. Our program brings together our renowned pediatric gastroenterologists, pediatric surgeons, urologists and skin, wound, ostomy nurses to work with patients and families to develop short- and long-term plans, including surgery and follow-up care.

Meet our multidisciplinary team of colorectal specialists.

The Only Dedicated Pediatric Colorectal and Urogenital Treatment Center in the Region

The CHOC Colorectal and Urogenital Center specializes in providing expert diagnosis and second opinions for colorectal disorders, as well as developing personalized treatment plans using advanced diagnostics and the latest research-based treatment options. We also provide specialized, ongoing care to children who are experiencing bowel management complications, such as constipation or incontinence, after surgery to correct a colorectal disorder.

We are the only program in the region to provide the multidisciplinary care of a pediatric gastroenterologist and pediatric surgeon in one convenient appointment. Our membership in the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) offers patients and families unique access to leading-edge treatments, information and clinical studies.

Colorectal and Urogenital Services at CHOC

Multidisciplinary diagnosis and treatment planning. Upon referral, patients undergo tests to determine the best way to care for their colorectal condition. Families will meet with our expert colorectal surgeons, motility gastroenterologists, urologists, skin and ostomy nurses and a nursing care coordinator during their appointment. Together, the providers will develop a comprehensive treatment plan with the child and family.
Specialized colorectal surgery. Our renowned colorectal surgeons offer surgical treatment for patients with anorectal malformation based on individualized treatment plans and comprehensive team-centered planning. Your child’s gastroenterologist and urologist will accompany the surgeon during many procedures, meaning that your child will benefit from the expertise of each physician when they need it most.
Long-term postoperative colorectal care. Most children require long-term follow-up care after colorectal surgery. This incredible long-term medical management is available not only to patients who have received surgical treatment at CHOC, but also to those who have not. Some patients may need to be seen in our clinic on a monthly basis while other patients may need to be seen three to four times a year.
Gastroenterology Motility Program. We offer extensive gastrointestinal motility testing in our state-of-the-art Motility Procedure Center. Our motility specialists perform anorectal manometery, colonic manometry, anal Botox® injections and biofeedback therapy.

Care and Compassion Now and in the Future

CHOC’s pediatric gastroenterologists and surgeons believe that testing and treatment should be individualized for your child’s medical and emotional needs, while always being mindful of your family’s values. We work with you to make sure all of your concerns regarding your child’s medical issues are addressed, and that you understand the testing strategies and treatment options available for your child’s condition. Our team is dedicated to the long-term well-being and needs of all our patients—throughout childhood and beyond.

What We Treat

Patients are referred to the CHOC Colorectal and Urogenital Center for advanced testing and treatment of colorectal disorders, including:

Bladder exstrophy
Chronic intestinal pseudo-obstruction (CIPO)
Cloacal anomalies
Colonic atresia
Difficult-to-treat or chronic constipation
Fecal incontinence
Hirschsprung disease
Imperforate anus
Inflammatory Bowel Disease (IBD), including Crohn’s disease and ulcerative colitis
Neurogenic bladder
Spina bifida

Advanced Diagnostics and Individualized Treatment

Colorectal and urogenital disorders are complex. Our multidisciplinary team works together using advanced diagnostics to create treatment plans that are mindful of your child’s medical, physical and emotional needs both now and in the future.

Anal Neural Mapping

Examination performed under general anesthesia to assess the precise location of the rectal opening relative to the muscular sphincter complex.

Anorectal Manometry

A non-invasive test that measures rectal nerve reflexes, pressure of the anal sphincter, coordination between the muscles involved in defecation, and the ability to squeeze and sense. It provides insight into the underlying problems in the mechanics of defecation.

Biofeedback Therapy

Scheduled sessions involve patients using their abdominal and rectal muscles to control computer programs much like a video game. The goal of this type of treatment is to “retrain” the coordination between the muscles and nerves that are used for bowel movements.

Botox Injections

Botulinum toxin injections are used to relieve increased pressures in the anus in conditions such as anal achalasia or post-surgical Hirschsprung’s disease patients.

Cecostomies for Antegrade Colonic Enemas

This is a procedure to relieve severe constipation that does not respond to medications.

Cloacagram

3-D imaging used in females diagnosed with a cloacal anomaly that shows the patient’s overlapping structures, as well as a measurement of their common channel. This information is important in the planning of cloaca repair surgeries.

Colonic Manometry

This test measures contractions in the colon. It provides an understanding of the underlying movement in the colon.

Colorectal Transit Study

This study measures the time needed for stool to pass through the gastrointestinal tract, and utilizes X-rays and radio-opaque markers.

Defecography

Defecography uses an X-ray to look at the shape and position of the rectum as it empties.

Intestinal Fluoroscopic Imaging

Imaging study where a catheter is inserted into the GI tract, followed by the administration of a contrast-containing liquid, which allows X-ray images to be taken, showing the position, diameter, and overall configuration of the GI tract.

Malone Antegrade Continence Enema (MACE)

A surgically created channel between the abdomen and the colon that allows for enemas through the beginning of the colon down to the rectum.

Video-Urodynamics

A study that involves inserting a small catheter into a child’s bladder to measure bladder pressure. This is helpful in understanding how well a child’s bladder fills and empties.