Bowel surgery is when a doctor fixes a defect or removes part of the bowel by opening up the abdomen or using minimally invasive techniques. There are many types of bowel surgery, each designed to treat a specific condition or challenge.

Surgery may be an option for kids with:

• Chronic constipation
• Bowel control problems
• Severe reflux
• Feeding issues
• Inflammatory bowel disease like Crohn's disease or ulcerative colitis
• Congenital disorders, like Hirschsprung disease, bowel atresia, anorectal malformations and others

Your child’s care team will explain which surgery is right based on their diagnosis, age and overall health.

Some children have constipation from a nerve or muscle issue in the bowel. In these cases, a cecostomy may help. A cecostomy creates a small opening in the first part of the large intestine.

Adding fluid (and enema) through this opening can flush stool out of the colon. This helps prevent accidents and gives kids more control over their bowel movements.

Digestive issues like Crohn’s disease, ulcerative colitis or necrotizing enterocolitis can damage the intestines. Surgery to remove damaged parts of the intestine can relieve symptoms and save healthy bowel. Surgery is often part of a longer treatment plan that may involve more procedures over time.

• Bowel resection: Often the first step for a diseased, blocked or damaged bowel. The surgeon removes the affected part and reconnects the healthy ends. When they take out a lot of the bowel, it can affect how the body digests food.
• Proctocolectomy: Surgery to remove both the colon and rectum.
• Ileostomy: Surgery to create an opening on the abdomen. Waste exits the small intestine through the hole into a collection bag. This may be temporary or permanent.
• Ileoanal reservoir (J-pouch): This is an option for kids who’ve had their colon and rectum removed but still want to pass stool through the anus. The surgeon uses part of the small intestine to form a pouch that stores stool and connects it to the anus. This procedure avoids a permanent stoma.
• Colostomy: Surgery to connect the colon to an opening in the abdomen. Waste exits the colon through the hole into a collection bag. This may be temporary or permanent.
• Colonic pull-through surgery: For some kids with a colostomy, surgeons can later reconnect the healthy bowel to the anus. This allows your child to pass stool normally out of the anus and may eliminate the need for a permanent colostomy.

Your care team will walk you through which option is best for your child and what the next steps might look like.

Some babies are born with differences in how their intestines form. These can block the normal movement of stool through the digestive system. They often require surgery to fix.

• Malrotation and volvulus: Some kids are born with intestines that are in the wrong position or twisted. The Ladd procedure untwists and repositions them. This surgery is often done urgently to prevent damage.
• Hirschsprung disease: Some babies are born without nerve cells in part of the colon. Surgery removes the part of the bowel that isn’t working. Some kids may need a temporary ostomy.

Some kids are not able to eat enough by mouth to grow and stay healthy. Feeding tubes go through the abdominal wall and can transport liquid nutrition. This keeps kids fed and growing, even when they can’t eat by mouth.

• Gastrostomy tube (G-tube): A G-tube goes directly into the stomach. It can be a short-term option during recovery or a long-term feeding solution.
• Gastrojejunal tube (GJ-tube): A GJ-tube goes through the stomach into the small intestine. It reduces reflux or vomiting from feedings into the stomach.
• Jejunostomy tube (J-tube): A J-tube goes directly into the small intestine. It’s an option for kids who cannot tolerate feedings into the stomach.

Some kids have reflux that does not improve with diet changes or medicine. In these cases, a surgery can prevent stomach acid and food from flowing back into the esophagus. This surgery is a fundoplication.

During this surgery, the surgeon wraps the top part of the stomach around the lower end of the esophagus. This creates a “high-pressure” zone that keeps food and acid in the stomach.

We know surgery can feel overwhelming. Our team is here to help you understand what to expect and support your child every step of the way. Below are common questions families have when preparing for bowel surgery:

Is bowel surgery always permanent?

Not always. Some surgeries, like colostomies or ileostomies, may be temporary. In some cases, once the bowel has healed, surgery can reverse it.

Will my child have a big incision?

Often no. Many surgeons use small incisions to access the intestines. This can reduce pain, lower the risk of infection and help your child recover faster.

Will my child still be able to eat?

It depends. Some kids may need a feeding tube or nutrition through a vein if they can’t eat enough by mouth. Our team will work with you to find the safest plan.

How long will recovery take?

Recovery depends on your child’s age, health and the type of surgery. Some kids go home in a few days, while others need more time in the hospital and follow-up care.