Bowel incontinence in children is characterized by frequent passing of stools, without voluntary control in the underwear or on the floor. There are several probable reasons for the occurrence of bowel incontinence in children; and prompt treatment and management are very important. Medicines, counseling and psychotherapy offer good results in the effective management of the condition.
Bowel incontinence is rather common, though most cases aren’t reported because of the child’s and / or parents’ mortification. It has been approximated that 1.5 % to 10 % children suffer from the condition; and it is commoner in boys than in girls.
Bowel Incontinence Symptoms
Symptoms and clinical manifestations of bowel incontinence include:
- Involuntary passage of stools.
- Loss of appetite.
- Loose, watery stools.
- Occasional abdominal pain.
- Scratching the anal area region.
- Reduced interest in physical activity.
- Withdrawal from family and friends.
- Guarded behavior with respect to bowel movement.
What Causes Bowel Incontinence In Children?
- The commonest etiological factor is chronic constipation; an inability to evacuate the bowels properly. Common reasons for obstipation include – inadequate water intake, insufficient intake of dietary fiber and presence of a sore at the anus.
- When a child gets constipated, a big lump of feces develops, and this stretches the rectal canal. Stretching dulls the nerve endings within the rectum, and the child does not sense the requirement to go to the toilet. The mass of stools may also get impacted; consequently, over a period of time, the muscles that keep the feces in the rectum will no longer be able to hold them back. Even though the big, hard masses of feces cannot pass through, liquid or loose stools will seep out, around the impacted mass of stools and onto the undergarments.
- Another likely cause is the colon’s inability to move the stool.
- The child may also develop incontinence of the bowel due to frustration and / or fear related to toilet training.
- Stressful and taxing events in the child’s life, like, illness of a family member or the coming of a sibling, etc, may be a contributing factor to the disorder.
- Occasionally, some children just decline to use the toilet.
Treatment For Bowel Incontinence In Children
First and foremost, your health care practitioner will manage sever constipation in the child; along side, he will give medicines to mange any associated symptom that may be present. If symptoms are present, he will need to make an assessment by conducting a complete medical history and physical inspection. X-rays and sonograms may need to be done to rule out other possible causes for obstinate constipation.
The aim of the treatment plan is to put a stop to constipation and promote good bowel habits. Education of the family and the child about the disorder is an essential aspect of the treatment.
Treatment commences with clearing feces that have got impacted within the colon. Then, the bowel movements need to be made normal, so that the stools are soft and easy to eliminate. The child’s diet needs to be altered, so that he eats more vegetables and fruits and drinks plenty of water. Also make sure that you schedule adequate trips to the bathroom and encourage and reward positive changes in the toilet habits.
Counseling, cognitive behavior therapy and psychotherapy yield brilliant results. This will help the child deal with the embarrassment, guiltiness and loss of self esteem that is associated with the disorder.