Incontinence and Constipation
Incontinence is the loss of control or leakage of the bladder or bowel. Children may experience daytime or nighttime (bed wetting) urinary incontinence. Stool incontinence (encopresis) can also occur.
Constipation is infrequent bowel movements or the difficult passage of stools. Due to increased pressure on the bladder and surrounding muscles, constipation can lead to daytime and nighttime urinary incontinence.
Normal Bladder and Bowel Habits
Many parents have concerns about when their child should be fully continent or potty trained. However, bladder and bowel habits vary by a child’s age.
Bladder Habits
- When a child is one to three years old, it is typical to void 11 times per day. As they get older, their bladder capacity increases and the number of voids decreases. By age 12, children usually void five to seven times per day. This is the same as adults.
Bowel Habits
- By the age of four, a child typically has a bowel movement four to nine times per week.
For most children, day and night continence occurs between the ages of five and seven.
How can I get a referral to pediatric physical therapy?
Make an appointment with a primary care provider in our family medicine department or pediatrics department to discuss any concerns about your child’s bladder and bowel habits. Your child’s provider can treat underlying medical conditions and provide a referral for physical therapy as appropriate to your child’s needs, or to a pediatric urologist and/or gastroenterologist.
How can physical therapy help?
Your child may benefit from physical therapy if he or she is experiencing any of the following:
- Using the bathroom more than five to seven times per day
- Having wet underwear or accidents on a regular basis with normal activity or play
- Experiencing bedwetting issues despite being toilet trained
- Straining to have a bowel movement
- Fear of having a bowel movement
- Having stool streaks in the underwear on a regular basis
- Pain when having a bowel movement
- Using laxatives on a consistent basis
- Frequent complaints of tummy aches and pains
The goals of physical therapy will be specific to each child’s situation. However, they may include decreasing or eliminating urinary or bowel incontinence, bedwetting, and constipation.
What to expect during pediatric physical therapy:
At the first visit, your physical therapist will perform a thorough evaluation to assess how your child’s nerves, muscles, and bones are working and affecting the bladder and bowel function. Next, your therapist will create an individualized treatment plan based on her assessment. Your therapist will discuss the treatment plan with you, including the number of treatment sessions and activities that will likely be included in future therapy sessions to reach your child’s treatment goals.
Physical therapists use several approaches to treat bladder and bowel problems. They provide education about how the bowel and bladder work and how your child can be more aware of his or her body and the messages he or she receives. Information is also provided regarding dietary and fluid influences on bladder and bowel function. In addition, exercise and muscle re-education are used to retrain pelvic floor, abdominal, and leg muscles. Biofeedback may be used to improve muscle contraction and/or relaxation. Manual (hands-on) techniques may be used to improve muscle tone.
