Pelvic Health Conditions in Children
Constipation in Children
The Facts
Did you know that between 10-20% of children are constipated?
That is about 1 out of every 5 children! Some signs of constipation are obvious; only pooing every few days; super large poos or rabbit pellet poos that are dry and painful to push out. But, there are some signs that may not be so obvious. For very small children: difficulty potty training, hiding to do a poo, straining to do a poo are all classic signs of constipation. For children who are potty trained: belly pain, skid marks on their undies or an itchy anus, frequent urination, wee or poo leaks during the day, pooing many times in a day, very loose runny poos and bedwetting, can all be signs of constipation.
Choose Your Poo!
We want kids to be doing type 4 or 5 poos every day! If that isn't happening, they are very likely constipated.
I don't think my child is constipated
“Wait, if my child is having multiple poos a day or their poo is super soft then they surely can't be constipated? And bedwetting is about wees, not poos?”
I am going to try and explain some of the facts to help you understand better
Multiple poos a day
If a child is pooing multiple times a day they are probably not emptying properly and this can happen for a few reasons. The most common reason is that they have been constipated for a while and their rectum is stretched and actually can’t empty itself fully. Pooing more than twice a day can be a sign of constipation.
Very Soft/ Runny Poos
“My child is having super soft poos every day, there is no way she is constipated?” If your child is very constipated the super hard poo stays where it is and the runnier poo behind it oozes past. This can sometimes result in a poo leak or else the child goes to the toilet but again they are still backed up! If they are having daily poos or having the other signs like complaining their tummy is sore, bedwetting or skid marks in their undies they are most likely constipated (Remember 1 in 5! So if your child is in a class of 20, 4 of those children are chronically constipated!)
Bedwetting and Daytime Accidents
Bedwetting is a direct consequence of constipation. Why is this? A child’s pelvis is already so small and if you have a rectum that is filled with poo it doesn’t give the bladder much room at all and that poo keeps pushing on the bladder (if you have had someone push on your bladder you know you need to GO). Children who bed wet, or have leaks of their wee or poo during the day are needlessly shamed when actually they are just super backed up. The biggest thing is IT'S NOT THEIR FAULT!
What can Physio do for Constipation?
Assessment
Every child and family is different and we will do a comprehensive examination of each child to make sure we have the whole picture. This assessment consists of a thorough history taking and possibly asking to chart your child bladder and bowel movements. We do NOT do any invasive pelvic floor examination techniques.
There is a pre-questionnaire to fill in before you come so please make sure you have that with you.
Treatment
Physiotherapy forms part of a multidisciplinary team when it comes to Constipation. Your paediatrician may put your child on stool softeners, which are very important but the role of the Physio is to help change behaviours, postures and techniques to solve cause and not just treat the symptoms.
Our treatment will depend on what we have found on assessment but may include behavioural changes, toileting positioning and scheduling, breathing techniques, abdominal massage, general education and problem-solving.
Reference: Hodges, Steve J. Schlosberg, S. (2012) It’s No Accident: Breakthrough Solutions to Your Child’s Wetting, Constipation, UTIs, and Other Potty Problems. Guilford, Connecticut: Lyons Press.
Bedwetting and Daytime Accidents
Bedwetting and daytime accidents are mostly a consequence of constipation. Why is this? A child’s pelvis is already so small and if you have a rectum that is filled with poo it doesn’t give the bladder much room at all and that poo keeps pushing on the bladder (if you have had someone push on your bladder you know you need to GO). Children who bed wet, or have leaks of their wee or poo during the day are needlessly shamed when actually they are just super backed up. The biggest thing is IT'S NOT THEIR FAULT!
Potty Training
Mandy Roscher is our resident Potty Training Physio.
What does she have to say about potty training?
After treating a lot of children for pelvic health problems I realised that a lot of problems started around potty training. I also went through a difficult potty training journey with my little girl and it made me realise that parents need help!
I started Potty Training Physio as a way of educating parents on bladders and bowels. Potty Training should not be difficult and if you are struggling there is help available! Make sure you are teaching your child healthy bladder and bowel habits
I developed a step by step POTTI training programme to take parents right from the beginning of deciding when your child is ready and the preparation for potty training all the way to night training and troubleshooting common problems.
It is broken into a step by step guide that is easy to follow and simple to implement.
I have also created a Quick Guide to Potty Training to help get parents started on their Potty Training journey.
Find out more about Potty Training
