Thu 10, Feb 2022

As a Pelvic Health Physiotherapist, I regularly see children and their families to help improve their continence issues. Most children are primary school age from around 5 -12 years old. Common issues include nocturnal enuresis (bedwetting), day wetting, urgency, giggle incontinence and faecal incontinence.

Approximately half of the children I see have been referred from a Paediatrician or GP, and the other half have found my clinic and self-referred. Delays in reaching bladder or bowel control are common in children. Having a regression or relapse after having no previous issues for some time is also quite frequently seen in clinic.

Goal setting with the child and family is key to ensuring that everyone is on the same page. Some children are not outwardly concerned about their issues, some kids are used to it and don’t always notice it as an issue. However, for many children, daytime wetting or faecal incontinence can occur outside the home and becomes quite a sensitive and embarrassing condition that affects their wellbeing and family life. 

On many occasions, bladder and bowel continence issues are a result of functional issues. For example, it may be that a child has difficulty emptying their bowel or bladder due to the way they sit or use their muscles of the abdomen, legs, and pelvic floor. Pelvic Health Physiotherapists are perfectly placed to recognise and educate children on muscle control, posture, great bladder habits, bowel habits and customising this to patients and their family’s needs. 

Bedwetting is a common condition that is very disruptive to families and often involves a combination of causes.  Taking a good history and completing a bladder and bowel diary are often used to optimise bladder and bowel function prior to any other intervention. Sometimes low fluid intake may cause small bladder volumes, or constipation may impact the bladder capacity and function. If the bladder and bowel are functioning well then a bedwetting alarm can help train the child learn to be aroused when a full bladder signal is sent to the brain. This takes some persistence and commitment from the family involved and is often used in conjunction with medications if the leakage volume remains high. If done well and under good guidance, the bed alarm training can eliminate bedwetting for many children. 

I love seeing children and their families in my clinic. I always feel a great sense of achievement for them in seeing them understand their bodies a little more and gain confidence and control over their issues. Occasionally we see issues that are not a functional problem and need further specialist care, however on many occasions I feel that I have helped prevent a lifelong issue.

As a Physiotherapist who also regularly treats adults who have suffered childhood bladder and bowel issues, I often wish I could rewind the clock for them and help prevent many years of inconvenience, troubles and stress for them and their families. So please reach out if you or someone you know is experiencing childhood continence issues. Seeking help might transform their lives.

Vanesa Wilmot

Bayside Pelvic Health

 

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