It looks like your browser is out-of-date! For the best user experience, please upgrade to a more modern browser like Chrome or Edge.

Skip to Main Content
Visitor Guidelines | Directrices de visitas

We are taking thoughtful steps to ensure our spaces remain safe for patients, parents and caregivers. View safety measures, mask policy and visiting guidelines.

Estamos adoptando medidas reflexivas para garantizar que nuestros espacios sigan siendo seguros para los pacientes, los padres y los cuidadores. Vea las medidas de seguridad, la política de uso de mascarillas y las directrices de visitas.

Mobile sized logo
  • 317.944.5000
    • Schedule an Appointment
    • Refer a Patient
    • Plan My Visit
    • Pay a Bill
    • Make a Donation
    • Volunteer
    • Find a Career
    • Health Information
    • Find a Doctor
    • Departments & Programs
    • Support Services
    • Contact & Locations
    • Refer a Patient
    • My IU Health Patient Portal
Riley Children's Health
  • 317.944.5000
  • My IU Health Patient Portal
    • Schedule an Appointment
    • Refer a Patient
    • Plan My Visit
    • Pay a Bill
    • Make a Donation
    • Volunteer
    • Find a Career
Book Appointment Online with select physicians.
Request Appointment Online to schedule with one of our coordinators.
1.888.IUHEALTH for
Same-Day Primary Care Appointments.
If you are experiencing a medical emergency, please call 9-1-1.
    • Schedule an Appointment
    • Refer a Patient
    • Plan My Visit
    • Pay a Bill
    • Make a Donation
    • Volunteer
    • Find a Career
  • Health Information
  • Find a Doctor
  • Departments & Programs
  • Support Services
  • Contact & Locations
  • My IU Health Patient Portal
  • General Information
    317.944.5000
  • Health Information
  • Find a Doctor
  • Departments & Programs
  • Support Services
  • Contact & Locations
Riley Children's Health

Malone Antegrade Continence Enema (MACE) Program

Departments Banner MACE

Contact MACE Program

317.944.3774
  • Find a Doctor
  • Request An Appointment
  • On This Page:
  • Conditions & Services
  • Doctors & Locations
  • Program Forms & Resources
  • Related Departments
  • For Health Professionals
Go back to the top of the page

Children with severe constipation who do not respond to medical therapy and children who suffer from fecal incontinence (lack of control of bowel movements) may not want to eat and often feel uncomfortable and have a reduced quality of life.

The Malone Antegrade Continence Enema (MACE) Program at Riley at IU Health provides a treatment to restore normal bowel function. This treatment helps your child return to school and regular activities and enjoy eating again. The MACE Program at Riley at IU Health is the only one of its kind in Indiana. We provide care to children from across Indiana, as well as from many other states.

Board certified pediatric gastroenterologists and surgeons lead the MACE program, which offers a surgical way to clean out the colon. Before your child is approved for the MACE procedure, doctors will perform a full medical workup to rule out any underlying conditions. A physical examination may be combined with:

  • Motility tests. These tests are performed to study the function of the intestines and rectum. Types of motility tests include:
    • Antroduodenal manometry
    • Colonic motility study
    • Anorectal manometry
  • Magnetic resonance imaging (MRI). A magnetic resonance imaging (MRI) scan of the spine will check for possible nerve damage.

If your child is a candidate for the MACE procedure, he or she will have surgery that creates a way to deliver enema fluid to the large intestine. The appendix is used to build a passageway from the belly button to the large intestine. The enema fluid is inserted through a catheter in the belly button using a gastrostomy button. The enema is given to clean out the colon.

The MACE procedure is highly successful at resolving constipation and fecal incontinence. Once your child's condition is corrected, you can expect:

  • Reversal of the procedure. The MACE procedure can be reversed because the colon is left intact.
  • Removal of the button. The gastrostomy button can be removed.
  • Return to normal. Bowel movements will return to normal.

The MACE Program drastically changes the lives of the children it treats. After the MACE procedure, children say they enjoy:

  • Improved quality of life
  • An increased interest in eating
  • Increased calorie and nutritional intake

The MACE Program completed a published quality-of-life study of its patients and documented an increase in the average quality-of-life rating after device placement. The study found:

  • Lower quality-of-life rating before treatment. An average quality-of-life rating of 64 percent before the procedure.
  • Improved quality-of-life rating after treatment. Quality of life improved to a 90 percent rating six months after surgery.
  • Maintained higher quality-of-life rating a year later. At 12 months post-procedure, patients rated their quality of life at 92 percent.

Children are monitored at the twice-monthly MACE clinic. Your child's doctor will see him or her three months after the procedure and then every three or six months depending on your child’s condition.

Conditions & Services

Conditions Treated

Our pediatric specialists provide patient- and family-centered care for most related conditions. The links below provide more specific information about some, but not all, of the conditions that we treat.

  • Constipation

Services Offered

We offer a number of different Malone Antegrade Continence Enema (MACE) Program services. Below are some, but not all, of the services that we provide. If you have a question about a specific service that is not listed here, please contact our program.

  • Gastrointestinal Tubes (G-Tube)
  • Magnetic Resonance Imaging (MRI)
  • Motility Tests

Doctors and Locations

Doctors

The care your child receives through the MACE Program is managed by our specialized pediatric gastroenterologists.

2 Results
Joseph M. Croffie, MD profile image
Joseph M. Croffie, MD

4.7 out of 5 stars

(155 ratings)

Score is an average of all responses to care provider related questions on our nationally-recognized NRC Health Patient Experience Survey.

Learn About Survey

Pediatric Gastroenterology

317.944.3774
Frederick J. Rescorla, MD profile image
Frederick J. Rescorla, MD

4.8 out of 5 stars

(83 ratings)

Score is an average of all responses to care provider related questions on our nationally-recognized NRC Health Patient Experience Survey.

Learn About Survey

Pediatric Surgery, General Surgery, Surgical Critical Care

317.944.4681

Specialties:

Accepting New Patients

Primary Location:

Get Directions

View Profile
Watch Bio Video

Locations

Locations

In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.

Riley Pediatric Gastroenterology, Hepatology & Nutrition

4.7 out of 5 stars (1,089 ratings)
Score is an average of all responses to care provider related questions on our nationally-recognized NRC Health Patient Experience Survey.
Learn About Survey

575 Riley Hospital Dr
Indianapolis, IN 46202

317.944.3774

Get Directions

View location information

See all facilities →

Program Forms & Resources

Program Forms & Resources

The Malone Antegrade Continence Enema (MACE) Program at Riley at IU Health provides the following forms for parents, healthcare providers and personnel. We have also curated relevant resources from other websites and provided links with brief descriptions of the information that is available.

Resources

  • GIKids

    This website for children and parents is maintained by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. This group provides information about many gastrointestinal conditions and treatments, including constipation and fecal incontinence.

Related Departments

Related Departments

We provide multispecialty care for a number of conditions. Below are links to our related departments.

  • Pediatric Gastroenterology, Hepatology & Nutrition
  • Pediatric Surgery

Health Professionals

For Health Professionals

The MACE Program at Riley at IU Health works with pediatric gastroenterologists throughout Indiana. Physicians send patients here for further evaluation when other medical treatments for constipation and fecal incontinence do not work.

We are actively involved in education to train physicians in the use of the MACE procedure.

Refer A Patient

Refer A Patient

Riley at IU Health works with referring physicians in Indiana and beyond.

Refer A Patient

Research

Physicians within the MACE Program are actively involved in research to improve patient outcomes for the MACE procedure.

Visit the Division of Pediatric Gastroenterology, Hepatology & Nutrition at Indiana University School of Medicine for information about the latest research in the field of gastroenterology.

Education

Physicians within the MACE Program help to educate the next generation of physicians by working directly with medical students, residents and clinical fellows at the MACE clinic.

Education Resources:
  • Medical Students
  • Residents
  • Fellowship
Riley Children's Health Indiana University School of Medicine
Designated as Best Children's Hospitals by U.S. News & World Report, Ranked in 10 Specialties in 2020-21

©2023 Riley Hospital for Children at
Indiana University Health
Find adult services at iuhealth.org

Get Informed

  • About Riley Children's Health
  • Family Support Services
  • Health Professionals
  • Medical Education
  • Newsroom
  • Riley Connections Blog
  • Careers
  • Legal Notices

I Want To…

  • Schedule an Appointment
  • Refer a Patient
  • Plan My Visit
  • Pay a Bill
  • Make a Donation
  • Volunteer
  • Find a Career

General Information

317.944.5000

Connect with Riley at IU Health

  • Facebook
  • Twitter
  • YouTube
  • LinkedIn
  • Instagram
  • RSS
Designated as Best Children's Hospitals by U.S. News & World Report, Ranked in 10 Specialties in 2020-21

©2023 Riley Hospital for Children at
Indiana University Health
Find adult services at iuhealth.org


Non-discrimination Notice

  • English
  • Español
  • Français
  • Burmese
  • Pennsilfaanisch Deitsch
  • 中文
  • Nederlands
  • Deutsch
  • Hakha
  • 日本語
  • Karen
  • 한국어
  • Русский
  • Tagalog
  • Tiếng Việt
  • العربية
  • हिंदी
  • ਪੰਜਾਬੀ
Back to top of the page