• Emily Cupelli

Constipation and Incontinence in Children



Constipation and urinary incontinence seem to go hand in hand. Constipation (hard or infrequent “poop”) is a common, frustrating problem. Urinary incontinence (“peeing” or wetting underwear after toilet training) is also common and equally challenging. Research has found that when children have urine “accidents”, they are also more likely to be constipated, and vice versa.


Up to 21% of all toilet-trained children continue to have “accidents” after successfully toilet training. Symptoms range from “leaks or drips” to obviously wet clothing. Some children are “wet” every day. These “accidents” affect school, play, and normal socialization. What are some of the reasons for this problem?


It is estimated that up to 30% of all children will have chronic, recurrent, or episodic constipation. Functional constipation is a term often used to describe constipation that is not associated with a known medical diagnosis. It is also estimated at children with constipation are 6 times more likely to also have urinary symptoms.

Constipation and “Wetting”, why do they seem to go together?

Constipation occurs when the waste products within the intestine pass slowly, becoming hard and difficult to pass. Children who drink little also tend to have hard stools. Hard stools (“poop”) press on the bladder (the muscle that stores urine), and this can change how the bladder works. The muscles used to “hold in” may change, along with awareness of urges, and other important sensations used in toileting. Children who “wait until the last minute” (regardless of reasons) often hold back both urine and stool. This may lead to retained stool in the rectum, causing either bladder distention or increased urinary frequency. Eventually, the “holding” muscles, known as the pelvic floor, will also change and become less effective at both holding and releasing urine and stool.


Many specialists use the term “voiding dysfunction” or “bowel dysfunction” to describe this problem. It has been found that both can be effectively treated with “pelvic floor therapy” which may include changes in diet (especially water intake), behavior modification, and targeted exercises/neuromuscular re-education. This approach will help the child regain normal control of bowel and bladder, reducing the risk of urinary tract infections, belly pain, and other troubling symptoms. If you feel your child may be experiencing either or both symptoms, please call our office nearest you. To find your local office click here.


References

Cupelli ET, Escallier L, Galambos N, Xiang S, Franco I. Sensory processing differences and urinary incontinence in school-aged children. J Pediatr Urol. 2014 Oct;10(5):880-5. doi: 10.1016/j.jpurol.2014.01.002. Epub 2014 Feb 6. PMID: 24636484.


Sampaio C, Sousa AS, Fraga LG, Veiga ML, Bastos Netto JM, Barroso U Jr. Constipation and Lower Urinary Tract Dysfunction in Children and Adolescents: A Population-Based Study. Front Pediatr. 2016 Oct 3;4:101. doi: 10.3389/fped.2016.00101. PMID: 27752507; PMCID: PMC5046079.


https://www.jpurol.com/article/S1477-5131(18)30646-6/fulltext


Videos about constipation


The poo in you video

https://www.youtube.com/watch?v=SgBj7Mc_4sc

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