Understanding Children’s Incontinence: How a Continence Physiotherapist Can Help

Navigating the challenges of childhood bladder and bowel disorders can be daunting for any parent. If your child is struggling with issues like bedwetting, daytime wetting, constipation, or soiling, you’re not alone. 

In Australia, these conditions are more common than many realise, and support is available to help both you and your child manage and overcome these challenges.

In this article, we’ll explore common childhood bladder and bowel disorders, their causes, and how a children’s continence physiotherapist can help.

child incontinence physiotherapy sydney

What Is Children’s Incontinence?

Children’s incontinence refers to difficulties with bladder and bowel control that go beyond the age where such issues are typically expected. Common types include:

  • Bedwetting (Nocturnal Enuresis): Involuntary urination during sleep beyond the age of 6 years.
  • Daytime Wetting: Accidents that occur during the day after age 4-5 years, often due to urgency or postponement, or sometimes when they giggle or exercise.
  • Constipation: Frequent or incomplete bowel movements leading to soiling, urinary tract infections, bladder overactivity or frequency, tummy pain, and behavioural change such as irritability.
  • Soiling: Accidental passing of stools, often related to constipation.

How Common Are These Issues?

In Australia, 

  • 1 in 4 children have trouble with constipation,
  • 3 in 100 have poo accidents,
  • 1 in 10 toilet trained children aged 5-13 years wet their underpants during the day,
  • 1 in every 5 Australian children beyond the age of 6 years wet their beds, 
  • By adulthood, 1 in 100 are still wetting at night.

These disorders can significantly affect a child’s social interactions, school performance, and self-esteem. It can also lead to anxiety, embarrassment, withdrawal, and acting out. The impact extends to families, causing family tension and stress. 

Causes of Childhood Bowel and Bladder Disorders

It is important to remember that childhood constipation, soiling, bladder incontinence, urgency, and bedwetting are all medical problems. They do not happen because your child is lazy, naughty, or attention-seeking. 

Understanding the causes of childhood incontinence and constipation is essential for effective treatment. Contributing factors can include a complex interplay of:

  • Biological factors
  • Genetic factors
  • Environmental factors
  • Developmental factors

Our continence physiotherapists are experienced in assessing childhood bowel and bladder disorders to identify the cause of your child’s problem.

For instance, some parents are surprised to learn that constipation can be a common cause of bladder problems. A belly full of poo can leave little room for the bladder to stretch happily, and the bladder literally gets weighed down or squished into a tiny corner of the bony pelvis. Even poo accidents can occur because of constipation, when looser stool sneaks past a solid mass of impacted faeces, or the rectum doesn’t evacuate properly due to non-relaxing pelvic floor muscles.

children's continence physiotherapist

How Can A Children’s Continence Physiotherapist Help?

The International Children’s Continence Society (ICCS) endorses ‘Urotherapy’ as the primary treatment approach for childhood bladder and bowel issues. This method consists of various non-drug and non-surgical behavioural interventions, which are often managed by continence physiotherapists like us.

Research indicates that urotherapy is effective in treating childhood incontinence. A study completed in 2015 showed at the end of a 12-month follow-up period, 56 out of 100 children who received Urotherapy were cured of their bladder or bowel problems, whereas only 15 out of 100 children who were left to ‘grow out of it’ were cured. (Maternik M, Krzeminska K, Zurowska A. (2015) The management of childhood urinary incontinence Pediatric Nephrology Vol 30 (1):41–50)  

Our team utilises Urotherapy and will guide you and your child in developing healthy bladder and bowel habits and making necessary lifestyle adjustments. We provide instructions on using bladder and bowel diaries, offer sensation awareness training, and teach pelvic floor muscle awareness and relaxation. Additionally, we help with behavioural modifications, such as managing anxiety, improving toilet posture, and employing neuromodulation techniques.

What To Expect From Your Appointments

When working with one of our continence physiotherapists, you can expect:

  • Thorough Assessment: This is to understand your child’s specific condition and needs. Virtual children’s continence assessments are also available. 
  • Personalised Treatment Plans: Tailored strategies that address your child’s unique challenges.
  • Techniques and Exercises: Use of targeted exercises to improve bladder and bowel function.
  • Typical Number of Sessions: The number of sessions varies, however we suggest planning for 6 visits (one per month). Every child is different though, so be prepared for this to change accordingly. 

Partner With An Experienced Continence Physiotherapist

Addressing incontinence and constipation is crucial for your child’s wellbeing and development. As a team of experienced children’s continence physiotherapists, we can provide guidance and support to manage and overcome these issues effectively. 

If you’re concerned about your child’s toileting habits, don’t hesitate to seek professional help. For more information or to schedule an appointment, contact us today. We’re here to support you and your child on the path to improved health and confidence.

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