ABSTRACT
An 18-year-old male presents to your clinic for an evaluation. He has a history of Hirschsprung disease (HD) and underwent a colostomy creation in the newborn period. He underwent a Soave pull-through of the colostomy at age 6 months. He never had any episodes of enterocolitis. Over the past few years, he has been having daily fecal soiling. He reports that he stools one to three times per day, but has smearing accidents multiple times per day. He is not currently taking any medication or supplements, but has taken senna, Colace (docusate sodium), and Dulcolax (bisacodyl) in the past with varying degrees of success.
