Bowel Management in FAP

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Presentation transcript:

Bowel Management in FAP Ellie Bradshaw CNS Biofeedback St Marks Hospital

Presentation * Allowing for differences in polyposis and stages of treatment I will discuss some dietary modifications which can be used to regulate bowel function Discussion of strategies for bowel management such as managing frequency, urgency and incontinence

Diet and the Gut

Diets that can help pain and frequency Low Fibre/Low Residue Diet (soluble vs insoluble fibre) (Giving the gut less to do as in colectomy, adhesions) Exclusion Diets- Gluten free, Lactose free ,FODMAP

High Fibre Foods To Avoid Wholemeal, wholegrains and Rye Nuts, dried fruit Beans, sweetcorn, peas Skins stalks and seeds No more than 2 portions of fruit per day Avoiding vegetables with skins (eg jacket potato)

Bowel stimulants Nicotine Caffeine Alcohol Spicy food Artifical sugars (Sorbitol, Mannitol)

Medications Loperamide Fybogel Colesevelam Codeine All have action of slowing gut, reducing frequency and thereby forming loose stools

Continence

Continence

Incontinence Urge Incontinence (unable to make it to the toilet in time) Passive incontinence (No warning- can happen post defecation due to incomplete emptying, or at any time)

Containment Inserts or Plugs

Emptying Completely

Mini Irrigation

Irrigation

Conclusion Low fibre diet may help give the gut less to do- which can help pain, frequency, urgency and incontinence. Medication can be used in combination for frequency There are many ways of managing incontinence …never be afraid to say.