1. Bowel Management in FAP
Ellie Bradshaw CNS Biofeedback
St Marks Hospital

2. 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

3. Diet and the Gut

4. 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

5. 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)

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

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

8. Continence

9. Continence

10. 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)

11. Containment
Inserts or Plugs

12. Emptying Completely

13. Mini Irrigation

14. Irrigation

16. 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.