Skills for the Job: Dealing with continence issues

What continence issues can children face?
Continence issues – also known as wetting and soiling – cause great distress to many children and young people who often work hard to hide the fact that they have these problems. The wall of silence surrounding wetting and soiling leave many children and young people feeling isolated and in fear of being bullied or ridiculed.

But there are over a million children and young people in the UK who have wetting and soiling problems and an assessment and intervention by a health professional along with supportive family and school environments will often result in successful resolution of the problems.

Wetting and soiling while at school can be difficult to hide, especially if access to clean, private school toilets is not available. Bedwetting is not so apparent at school but children and young people who wet the bed will often avoid overnight school trips with peers.

What causes continence problems?
The most common causes of daytime wetting problems are urinary tract infections or an overactive bladder (where the bladder contracts very often and with little warning). Both of these problems can be resolved with help from health professionals – usually medication and/or bladder training. Soiling is usually a result of constipation and most childhood constipation is termed as idiopathic, occurring for no known reason. Soiling will usually resolve when an impacted bowel is emptied and remains clear. Prescribed laxatives taken over a lengthy period of time will clear the bowel and keep things moving.

How do you help a child with continence problems?
Children and young people who wet and soil have very little control over what is happening and without intervention from health professionals it will be very difficult to resolve the problems. For most childhood continence problems there is usually something that can be done to help and early referral to the school nurse or other health professional is always recommended. A child or young person with wetting or soiling problems will benefit from discreet and supportive teaching staff who allow easy access to the toilet when needed.

What can a school do?
For most children and young people with continence problems there is usually an underlying bladder or bowel problem and they have little control over what is happening to them. If they are not allowed access to the toilet when they need to go it is likely to result in an accident and humiliation.

• Involve the school nurse as early as possible to ensure that the child or young person and their family are receiving professional support to help resolve the problem.
• Be alert to the potential for bullying by addressing any wetting or soiling accidents as discreetly as possible.
• Respect the child or young person’s right to privacy about their condition.
• Ensure pupils have access to good quality drinking water so they can drink through the day, this will help with bladder and bowel function.

What support organisations can help?
Eric (Education and Resources for Improving Childhood Continence) provides support and information on all childhood continence problems. It can be contacted on 0845 370 8008 or email info@eric.org.uk. The website www.eric.org.uk features free downloadable resources. Eric also provides training on childhood continence problems.

PromoCon, part of the Disabled Living service (www.promocon.co.uk) also offers free downloadable publications on managing bowel and bladder problems in schools and early years settings.

Top tips

• Early intervention results in earlier resolution of the problem
• Enable easy access to toilets
• Those with continence problems fear “being found out” and experiencing ridicule or bullying
• Involve the school nurse and the child or young person’s family as soon as continence problems become apparent
• Healthy bladders and bowels need good fluid intake, so encourage children and young people to drink well

Eileen Jacques, information and helpline manager, Education and Resources for Improving Childhood Continence (Eric)