One Potty Problem After Another

Urinary tract symptoms can mean children have bowel issues as well

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) If potty training isn't going well with "Number 2" but the bladder is under control, it may be a sign your child has a problem with his or her bowels.

More than half of children with lower urinary tract symptoms have some problem with their bowels as well, a new study has found. This includes constipation or the inability to control their bowel movements.

Because of this, researchers "recommend evaluation of bowel habits as part of the initial assessment of a child presenting with urological symptoms."

"Help your child to the bathroom."

The aim of the study, led by Rosa Burgers, MD, from the Department of Pediatric Gastroenterology and Nutrition at Emma Children's Hospital in the Netherlands, was to see how often children with urinary problems had constipation or trouble holding their bowel movements.

People with this problem, called fecal incontinence, have little control of their bowels and can leak fecal matter.

The study included 113 healthy children, more than half who were girls, over a two-year period. The children ranged between 4 and 17 years of age and were referred by a doctor to an outpatient clinic for their lower urinary tract symptoms.

Children who had colorectal surgery in the past, took laxatives or were constipated by some natural cause were excluded from the study.

Parents were asked to keep track of their child's bowel habits for two weeks before the first visit.

At the examination, each child received a physical examination of his or her abdomen, anus, and genitalia. Doctors then gave them an ultrasound measuring the width of their rectum.

Rectums wider than 3 cm meant the patients had fecal matter, even if the child didn't feel they needed to go to the bathroom.

After the ultrasound, researchers found that more than 8 percent of the children had a wider than normal rectum.

In total, almost half of the children were constipated and another 11 percent couldn't control their bowel movements.

"In line with these findings, children with [difficulty controlling their bowels] sense the urge to defecate, but postpone normal defecation in the toilet and often leak stool during playtime while they continue their play instead of stopping for a moment to go to the toilet," the authors wrote in their report.

Further, 38 patients had overactive bladder and 46 had dysfunctional void, or felt the need to go to the bathroom more often than normal.

Of the children who were constipated, 63 percent of had dysfunctional void, 42 percent had the urge to go and 28 percent had some other urological disorder.

And of those who couldn't control their bowels, 21 percent frequently felt the urge to go, a little more than 2 percent had dysfunctional void and 10 percent had some other urological problem.

"Future studies regarding the effect of treatment of FDD [functional defecation disorder] on urological symptoms are justified," the authors wrote in their report.

The authors note a couple of limitations with their study, including the overestimation of bowel problems by parents.

Parents who completed the survey may have been more concerned and thus more willing to have their children participate in the study.

Plus, having the ultrasound may underestimate the amount of fecal matter in the children at the time.

The study, which was funded by Nuts Ohra, was published online November 1 in the Journal of Neurology. The authors do not report any conflicts of interest.

Reviewed by: 
Review Date: 
November 10, 2012
Last Updated:
November 11, 2012