Children who have had
a brain injury can sometimes have problems with toileting. After a brain injury, children who were previously toilet trained can become incontinent
(have no control over wee and/or poo) because the
usual mechanisms in the brain for controlling the bladder and/or bowel may be damaged.
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 the bladder completely, which then becomes an
infection risk
- dysuria - when passing urine is painful
- stranguary - problems with starting the urine
stream
- urinary urgency - the
sudden need to empty the bladder
What is the
treatment bladder incontinence?
In the early stages of
recovery, a child may require a catheter (a tube into the bladder) to
monitor how much urine they are making and how their kidneys are
working. A toileting regimen can be started as the child becomes more aware of their surroundings. Some simple measures can be taken
to help the child, such as toileting them at regular intervals and
reducing their fluid intake in the evenings. Using a reward chart
each time the child stays dry may also be useful. During
retraining, the child may need to wear a nappy or 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 (poo coming out frequently when they don't
expect it to).
What is the treatment for bowel incontinence?
To help prevent or treat
constipation, the doctor may prescribe either oral medications or
bowel preparations for the child. Choosing food that is high
in fibre, bulk or roughage - such as fresh fruits, vegetables and
wholegrain foods - will help keep your child regular. A toileting
program to encourage more regular bowel habits may also be
used.
Key points to
remember
- Following a brain injury, children who were
previously toilet trained can become incontinent, meaning wee or poo can
come out when you don't want or expect it to.
- Incontinence can occur when the usual
mechanisms in the brain for controlling bladder and bowel functioning are impaired.
For more
information
Developed by The Royal Children's
Hospital Paediatric Rehabilitation Service based on information from the Brain
Injury Service at Westmead Children’s Hospital. We acknowledge the input of RCH
consumers and carers.
Reviewed September 2020.
Kids Health Info is supported by
The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.