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Combating constipation in children: its link to bladder dysfunction and effective solutions

A young boy holding two toilet rolls to his eyes.

Bladder health is a crucial aspect of overall wellbeing in children, impacting their daily lives and self-esteem. When a child experiences bladder dysfunction, it can lead to issues such as overactive bladder, daytime wetting and night-time wetting, affecting both the child and their family. One often overlooked factor that can exacerbate these bladder problems is constipation. Understanding the link between constipation and bladder dysfunction is essential for effective management and treatment.


By addressing constipation, parents can help improve their child’s bladder health and alleviate associated problems. 


Understanding the connection between constipation and bladder dysfunction


What is constipation?


Constipation is a common condition in both children and adults, characterised by infrequent, difficult or painful bowel movements. A child may be considered constipated if they have fewer than three bowel movements per week, experience hard or dry stools or find it painful to pass stools. Constipation can vary in severity and can significantly impact a child's comfort and daily routine.


Common causes of constipation in children include:


  • Diet: A diet low in fibre and fluids can lead to hard, dry stools that are difficult to pass.

  • Lack of physical activity: Regular physical activity helps stimulate bowel movements. A sedentary lifestyle can contribute to constipation.

  • Behavioural factors: Children might ignore the urge to go to the toilet due to being preoccupied with play, fear of using unfamiliar toilets or previous painful bowel movements.

  • Routine changes: Travel, starting school or other disruptions to a child’s usual routine can affect their regular bowel movements.

  • Medical conditions: Certain medical conditions, such as hypothyroidism or Hirschsprung's disease, can cause constipation.


How constipation affects bladder function


The physiological link between constipation and bladder dysfunction is significant and often overlooked. When a child is constipated, the full bowel can press against the bladder, reducing its capacity and causing urinary issues. This pressure can lead to symptoms such as frequent urination, urgency and even urinary incontinence.


A full bowel can hinder the bladder's ability to empty completely, leading to residual urine and increasing the risk of urinary tract infections (UTIs). Additionally, chronic constipation can weaken the pelvic floor muscles, further exacerbating bladder control problems.

Research supports this connection. Studies have shown that children with constipation are more likely to experience urinary problems. For example, a study published in the Journal of Urology found that up to 30 per cent of children with chronic constipation also had bladder dysfunction symptoms such as urinary incontinence and urgency.


By understanding how constipation can impact bladder function, you can take proactive steps to manage both conditions, improving your child’s overall health and quality of life.


Recognising the symptoms of constipation


Recognising the signs of constipation in children is the first step in managing the condition and preventing its impact on bladder health. Parents should be vigilant for the following symptoms:


  • Infrequent bowel movements: Having fewer than three bowel movements per week.

  • Hard, dry stools: Stools that are hard, dry and difficult to pass.

  • Pain during defecation: Complaints of pain or straining while passing stools.

  • Abdominal pain: Frequent stomach aches or discomfort that may be relieved after a bowel movement.

  • Feelings of incomplete evacuation: A sensation that the bowel is not fully emptied.

  • Large stools: Stools that are unusually large in size.

  • Stool soiling: Unintentional leakage of liquid or pasty stool (encopresis), which can occur when a large stool mass blocks the rectum.

  • Appetite loss: Reduced appetite or feeling full quickly due to backed-up stool in the intestines.

  • Avoidance behaviour: Children may avoid going to the toilet due to fear of pain, leading to a cycle of worsening constipation.


Symptoms of bladder dysfunction related to constipation


Constipation can manifest through bladder-related symptoms, which might be more apparent to parents monitoring their child's urinary habits. Signs that bladder dysfunction could be related to underlying constipation include:


  • Frequent urination: Needing to urinate more often than usual, which can be caused by the pressure of a full bowel on the bladder.

  • Urgency: A sudden, strong urge to urinate, often with little warning.

  • Urinary accidents: Involuntary loss of urine during the day, known as daytime wetting.

  • Bedwetting: Wetting the bed at night, known as nocturnal enuresis, which may be linked to constipation.

  • Straining to urinate: Difficulty starting the urine stream or having to strain to empty the bladder fully.

  • UTIs: Recurrent UTIs may indicate incomplete bladder emptying due to constipation.


By recognising these signs and symptoms, parents can better understand the possible connection between their child's bladder dysfunction and constipation. This awareness is crucial for seeking appropriate treatment and improving both bowel and bladder health in children.


Effective solutions to manage constipation


Dietary changes


A balanced diet rich in fibre is essential for preventing and managing constipation in children. Fibre adds bulk to the stool, making it easier to pass and promoting regular bowel movements. Incorporating the following fibre-rich foods can help alleviate constipation:


  • Fruits: Apples, pears, berries, prunes and oranges are excellent sources of fibre.

  • Vegetables: Broccoli, carrots, peas and leafy greens like spinach and kale.

  • Whole grains: Whole wheat bread, brown rice, oats and quinoa.

  • Legumes: Beans, lentils and chickpeas.


Alongside a fibre-rich diet, adequate hydration is crucial. Water helps soften the stool, making it easier to pass. Encourage children to drink plenty of water throughout the day and limit sugary drinks, which can contribute to dehydration.


Establishing routine


Creating a regular toileting schedule can help manage constipation by promoting consistent bowel movements. Here are some tips:


  • Scheduled toilet time: Encourage children to sit on the toilet for a few minutes at the same times each day, such as after meals. This routine can help establish a regular pattern.

  • Responding to natural signals: Teach children to listen to their bodies and go to the toilet as soon as they feel the urge to avoid holding in stools, which can worsen constipation.

  • Positive reinforcement: Use positive reinforcement, like a reward system, to encourage regular toileting habits.


Physical activity


Regular physical activity plays a vital role in promoting healthy bowel movements. Exercise stimulates the intestines, helping to move stool through the digestive tract. Here are some child-friendly activities:

  • Outdoor play: Activities like running, jumping and playing on playground equipment.

  • Sports: Enrolling in sports such as swimming, football or dancing.

  • Family activities: Walking, hiking or biking together as a family.


Medical interventions


While lifestyle changes are often effective, some cases of constipation may require medical intervention. Over-the-counter remedies can provide relief, but it's essential to use them appropriately:


  • Laxatives and stool softeners: Products like polyethylene glycol (PEG) or lactulose can be effective. These should be used under the guidance of a healthcare professional.

  • Fibre supplements: These can help if dietary fibre intake is insufficient.


Before starting any treatment, it's crucial to consult a healthcare professional to determine the most appropriate approach for the child's specific needs. In severe cases, medical treatments may include:


  • Prescription medications: Such as stronger laxatives or medications to stimulate bowel movements.

  • Medical evaluation: Further evaluation to rule out underlying conditions that might be causing chronic constipation.


Support and resources for parents and children


Open communication about digestive and bladder health is crucial in managing and preventing issues such as constipation and bladder dysfunction. Here are some tips on how to approach these topics with your child:


  • Use simple language: Explain the importance of good digestive and bladder health in a way that is easy for your child to understand. Use terms like "tummy health" and "going to the toilet regularly" to make the conversation relatable.

  • Be honest and reassuring: Address any concerns or questions your child may have honestly, while reassuring them that these issues are common and manageable.

  • Create a positive attitude: Emphasise that taking care of their body is important and that they are not alone. Share stories of other children who have successfully managed similar issues.


Creating a supportive environment at home is essential for your child’s success:


  • Encourage open dialogue: Make sure your child feels comfortable discussing any problems or discomfort they may be experiencing. Let them know it’s okay to talk about these topics.

  • Be patient and understanding: Recognise that managing digestive and bladder health can be challenging for children. Offer patience and understanding as they navigate these issues.

  • Establish routines together: Involve your child in establishing healthy routines, such as regular toilet breaks, balanced meals and physical activity. This can help them feel more in control and motivated.


When to seek professional help


Knowing when to seek professional help is vital for effective management of constipation and bladder dysfunction. Here’s when to consider consulting a paediatrician or specialist:


  • Persistent symptoms: If your child’s constipation or bladder issues persist despite implementing home remedies and lifestyle changes, it’s time to seek professional advice.

  • Severe discomfort: Any signs of severe pain, significant discomfort or distress in your child should be addressed by a healthcare professional.

  • Recurrent issues: If constipation or bladder problems frequently recur, a specialist can provide a more comprehensive treatment plan and investigate underlying causes.


Managing constipation is crucial for improving bladder health in children, as it can significantly reduce the risk of bladder dysfunction. By recognising the signs of constipation, implementing effective dietary and lifestyle changes and seeking professional help when needed, parents can support their child's overall wellbeing.


We encourage parents to take proactive steps to address constipation and bladder health. Early intervention can make a substantial difference in your child's quality of life. Don't hesitate to reach out for professional advice and support if you encounter persistent issues.


Take the first step towards improving your child's bladder and bowel health by contacting PeePS today. We offer a free, 15-minute discovery call with our paediatric urology specialist to discuss your child's needs and explore how we can help.



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