This leaflet is for caregivers of children who may require an antegrade continence enema ACE. It provides information on the ACE in children, including information on the operation itself, alternative treatments and care given before and after surgery. Please keep this leaflet for reference as it contains information about continuing care and problem-solving at home.
An antegrade continence enema, commonly referred to as an ACE but also referred to as a MACE , is a method by which the bowel can be emptied to help in the management of constipation and faecal soiling that is, the leakage of faeces or poo other than during a bowel movement. An ACE may be recommended when alternative methods fail see section of alternatives below.
In most cases, constipation and soiling for any of the above reasons can be managed with alternative methods to the ACE see section on alternatives below. Formation of an ACE is therefore reserved only for children for whom all other methods of treating constipation and soiling have been trialed over many months, with full commitment from the child and family, and yet symptoms have not improved.
Risks, complications and problems may occur at the time of surgery rare , in the initial weeks after surgery when the indwelling catheter is in place and in the long term more common.
Complications at the time of, and immediately after, surgery are rare but include:. Alternative therapies for the management of constipation and soiling can be grouped as follows:. The decision to proceed with formation of an ACE is a significant one. Therefore you and your child will meet with a team of experienced specialists. It is not uncommon that surgery to form an ACE is delayed to allow the child time to be adequately prepared for their ACE washout regimen.
