Bladder and Bowel Incontinence

Disclaimer: This information sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What is it?

Children who have sustained a brain injury can sometimes have difficulty with toileting. Children who were previously toilet trained can become incontinent after a brain injury because the usual mechanisms for controlling the bladder and bowel in the brain may be impaired.

Bladder or Urinary Incontinence

Children often experience urinary problems such as:

• Incontinence - the accidental loss of urine
• Urinary Frequency - the need to empty the bladder more than once every two hours
• Urinary Retention - the inability to empty your bladder completely, which then becomes an infection risk
• Dysuria - painful passing of using
• Stranguary - problems with starting the urine stream
• Urinary urgency - the sudden need to empty your bladder

What is the treatment?

In the early stages of recovery, a child may require a catheter/tube into the bladder to monitor how much urine they are making, and how their kidneys, which filter wastes from the blood are working. As the child becomes more aware of their surroundings, a toileting regime can be started. Some simple measures can be taken to help the child, such as toileting them at regular intervals and reducing their fluid intake of an evening. Using a reward chart each time the child stays dry may also be useful. Whilst retraining the child may need to wear a nappy/incontinence pad.

Bowel Incontinence

Children with a brain injury may also experience problems with their bowels. A combination of factors such as mobility, inactivity, diet, medications and impaired thought processes can contribute to this problem. If a child is very constipated then they can have overflow incontinence of faeces.

To help prevent or treat constipation the doctor may prescribe either oral medications or bowel preparations for the child. Choosing foods that are high in fibre, bulk or roughage, such as fresh fruits, vegetables and wholegrain foods may also help, as well as a regular toileting program to encourage more regular bowel habits.

Each child has different needs when it comes to continence. Please consult with your health care worker to develop the appropriate toiling regime for your child.

Rehabilitation Department The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 2132 - Fax: (02) 9845 0685 http://www.chw.edu.au/rehabilitation/