4. Management of bladder and bowel:
Most
children with spina bifida will have some problem with bowel and
bladder. This will range from full control to total incontinence.
Parents will need to discuss the most appropriate management for
their child’s bladder and bowel problems. The aims of the
treatment of bladder incontinence are:
- To
keep the kidney healthy
- To
keep the child and his cloths dry and free of urine for reasonable
acceptable time.
Bowel:
Most bowel problems in children of spina bifida are managed by
diet to regulate stool consistency and by toilet training.
- Diet
– Food controls the consistency of the stools in all
children. For the children with bowel incontinence, food can
be used to make the stool firmer or softer depending on the
amount of fiber it contains. High fiber diet and if required
laxatives are used.
- Toilet
training
- Daily
enemas – In some patients,
daily enemas are helpful. Some patients require only one daily
enema but in few patients enemas may be required upto 2 times
a day.
How
is spina bifida prevented?
Spina
bifida is a birth defect that occurs very early in pregnancy.
The defect develops between the 17
th to 30
th
day after conception, usually before woman knows she is pregnant.
The
US public health service recommends that all woman of childbearing
age should consume 400 mg (0.4mg) of folic acid every day, to
reduce their risk of having NTD affected pregnancy. The folic
acid supplementation ideally should be started 3 months before
and continued till 3 months after pregnancy. It is very difficult
to know for a woman when she will become pregnant. So all women
capable of becoming pregnant; not just those planning a pregnancy
should consume enough folic acid every day. Women who are planning
a pregnancy should eat more folate rich foods and avoid over cooking
them.
Secondary
prevention includes the screening and the options of selective
termination of pregnancy.
Last updated on 30-10-2001
