One Youngster's Super Power: Living Joyfully With a GI Disorder

In her pink superhero cape embellished with a blue letter A, 5-year-old Ava Loveland is bursting with energy. Watching her play, you would never guess she has faced health challenges.

Yet, up until last summer, Ava’s natural exuberance was dimmed a bit. Since birth, she had been plagued by the discomfort of chronic constipation. Her tummy was distended, and she wasn’t gaining much weight,” recalls her mother, Alexis Loveland, an emergency medical technician.

Worried, Alexis had taken her daughter to see other doctors before coming to UH Rainbow Babies & Children’s Hospital. But none were able to find a cause for Ava’s persistent constipation or a treatment that relieved it.

After four years of frustration, Alexis decided it was time to seek another opinion. So, she brought Ava to see Ramy Sabe, MD, a pediatric gastroenterologist with UH Rainbow Babies & Children’s Hospital at the Canfield, OH office. Right away, Alexis knew they had come to the right place. “Dr. Sabe actually listened to what I had to say,” she says.

At Last, Treatment Success

“About 15 percent of kids have constipation,” Dr. Sabe  says. “In most cases, it’s due to a lifestyle issue, such as a change in routine, toilet training, pain with bowel movements, not staying hydrated, not eating enough fiber or being distracted while sitting on the toilet – kids have a lot more fun things to do than pooping! But in about 5 percent of kids with chronic constipation, it’s caused by an underlying disorder.”

Doctors had tried various oral medications to treat Ava’s constipation, but they hadn’t solved the problem. So, Dr. Sabe ordered several tests. They revealed that Ava had colonic dysmotility, a disorder in which the colon (large bowel) doesn’t move properly.

To treat the disorder, Ava needed a cecostomy, a surgical procedure in which a tube is inserted through the lower right abdomen into the first part of the large bowel. Thereafter, fluid containing medications can be delivered straight to the bowel through the tube. This flushes out the bowel, preventing constipation. When not in use, the outer opening of the tube can be tightly sealed with a cap.

Ava’s surgery was performed last August by Edward Barksdale Jr., MD, Surgeon-in-Chief and Chief of Pediatric Surgery at UH Rainbow Babies & Children’s Hospital. “Dr. Barksdale did an amazing job,” Alexis says. “Ava had her surgery on a Thursday and was home by Saturday night. She had one dose of pain medication directly after surgery and then she was up, running around and playing.”

Life With a Cecostomy Tube

Today, thanks to nightly bowel flushes through her cecostomy tube, Ava is thriving. “She gained 7 pounds in the first two months after surgery because she was eating more,” Alexis says. “She’s also happier and playing more now.”

Dr. Sabe says, “Constipation is a common cause of abdominal pain in children. If it continues over time, it can lead to worsening symptoms and sometimes bowel accidents. Some kids also begin to fear having a bowel movement because it’s usually large and painful when they do. Getting their chronic constipation under control can greatly improve these kids’ quality of life.”

Ava, who likes to wear her superhero cape when she visits Dr. Sabe, is a shining example. She’s a bundle of enthusiasms, from My Little Pony to playground slides. She can even go swimming with the cecostomy tube in place. Now there’s nothing holding this super-kid back from enjoying all the things she loves.

Related Links

The pediatric gastroenterology team at UH Rainbow Babies & Children’s Hospital offers state-of-the-art diagnostic testing. The team also provides a wide range of treatment and management options, including medications, endoscopic procedures, anorectal biofeedback, pelvic floor strengthening, nutrition evaluation, counseling and surgery. Learn more at UHRainbow.org/DigestiveHealth.