Children's Hospital Colorado
Sandy and Karsang talk to Gabriela and Adrian

Living with Cloaca

Looking ahead

Our families have many questions and worries about what life will be like for their daughters as they grow up. Will school life will be normal for them? When their daughters become adults, will they be able to have children? After meeting and hearing Linda's story, an adult who has cloaca and now a child of her own, they feel reassured.

Bowel management

Bowel control is a challenge for some patients with cloaca. At about 3 years old, when most children get out of diapers, our colorectal team helps cloaca patients start a bowel management program. The goal of bowel management is for a child to have a bowel movement once a day and remain clean between bowel movements. Bowel management includes the use of enemas and, when indicated, diet manipulation and medications.

Sandy and Karsang have found that enemas greatly improved Tashi's quality of life. They're glad they made the decision to take this step.

Learn about our Bowel Management Program

Long-term enema therapy

If a child needs enemas for life, they may be able to have an antegrade continence enema (ACE) procedure, also called the Malone procedure, when they are 5 to 8 years old. The ACE is an option for children who need long-term enema therapy, but who do not want to have daily enemas given by rectum. The ACE allows children to give their own enemas through a tube that passes through the abdominal wall.

Read more about the ACE procedure

Gynecologic and reproductive health

Girls born with cloaca have unique gynecologic needs and concerns from puberty through adulthood. Our multidisciplinary care team includes a gynecologist who is there to learn about your daughter's condition, establish trust and provide the ongoing care she'll need. This support is essential to your daughter's health and potential to have children if she wishes to start a family later in life.

Hope for the future

Sandy and Gabriela worry about their daughters' ability to have children when they become adults. Although there is no guarantee that Tashi or Allison can have children, Linda reassures them that their daughters can lead a normal life. And, maybe one day they, too, can have children of their own. The key is taking one day at a time and letting Tashi and Allison experience life like any other child.

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Browse and connect with world-class colorectal and urogenital surgeons at Children's Colorado.

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Meet more patients

Read inspiring stories about other patients born with an anorectal malformation and how they persevered.

See their stories
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Helpful resources

Our International Center for Colorectal and Urogenital Care is home to world-renowned surgeons, Alberto Peña, MD, and Andrea Bischoff, MD.

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"We honestly consider it a privilege to be able to be part of your journeys, to be able to have your trust, in ourselves, in our hands."

Dr. Andrea Bischoff
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Partnership with the University of Colorado School of Medicine

Children's Hospital Colorado partners with the University of Colorado School of Medicine, where many of our physicians and care providers serve as faculty.