ABSTRACT
A 12-year-old male presents to your clinic with a history of an anorectal malformation (ARM). The original malformation is unknown. He was initially managed with a colostomy and underwent a posterior sagittal anorectoplasty (PSARP) and colostomy closure in his first year of life. He subsequently underwent two reoperations for anterior mislocation of his anus and a stricture, as well as a Malone appendicostomy for antegrade enema administration. He participated in a bowel management program to determine the ideal flush regimen. His current antegrade flush regimen is saline 500 mL, glycerin 30 mL, and Castile soap 5.5 mL. He is clean on this regimen with only occasional stool accidents (one to two per month). The patient is interested in transitioning from antegrade flushes to laxatives.
