>> Hi, my name is Kari Dowds.
I'm one of the nurses in the Suzi and Scott Lustgarten Center for GI Motility at Children's
Hospital of Philadelphia.
This is an information video for parenting caregivers.
At the end of this video, if you feel it is appropriate for your child to watch, we suggest
that you sit down with your child and view it together.
>> Even though everyone has bowel movements, it's not always easy.
Our bodies make stool all the time and our stomach and bowel muscles need to work together
to get the stool out.
Sometimes these muscles get out of sync.
Biofeedback is a fun and noninvasive way to help your child see how their muscles are
working together.
With practice, your child can learn to get the muscles coordinated again.
Now let's see this in action.
>> Hi Kieran, how are you?
>> Good.
>> Good my name is Kari, I’m one of the nurses in the endoscopy suite.
I'm here to teach you about biofeedback.
>> These sessions take about ten to fifteen minutes and will occur weekly to every other week
During the first session, a nurse will explain to you and your child about the equipment
and how it works, what muscles are used when trying to have a bowel movement, and the proper
sitting technique when having a bowel movement.
They will also ask about your child's toileting and stooling patterns at home.
>> Okay?
So you know everyone has to poop, right?
Sometimes it's hard to poop.
Cause you have to use the right muscles.
You have to use your belly muscles and your bottom muscles.
So this is a special game that we use to see what muscles we are using
when we're trying to poop.
All it entails are six really small stickers.
>> Nothing is going inside of you.
We have three stickers that are going on your belly.
Two stickers are going on your bottom.
Nothing is inside, it's just going on your bottom right next to where the poop comes out.
And then the last sticker is going on your leg.
These stickers are connected to a machine and as you're pushing as if you're trying
to poop, you’re going to look up here and you’re going to see a fish and bubbles.
And you’re gonna try to get the fish to eat the bubbles.
Do you have any questions?
Okay.
>> Your child will sit on a special chair called a commode.
And we will ask them to bare down as if they are having a bowel movement.
As your child does this, they will be looking at a computer screen.
The act of pushing or squeezing will cause an object on the screen to move.
>> You will see fish on the machine.
This fish is controlled by your belly.
When you see these pink bubbles come around on the machine, push like you're trying to poop.
During this period you're resting and then as soon as you see pink bubbles - as soon
as your fish gets right up to it, you’ll push.
Okay ready?
And push!
Push push push push push push push push push push push push push keep pushing.
>> The visual and auditory cues will help your child learn which muscles they are using
to have a bowel movement.
During subsequent sessions, the nurse will reinforce this education and provide encouragement
to your child.
As the sessions continue, the nurse will began to take away the visual and auditory cues
to mimic the home setting.
They will also continue to evaluate your child’s progress at home.
>> Thank you so much for watching this video.
If you have any more questions, please contact your physician.
Your child's care is our top priority.