Comprehensive range of products to help improve childhood continence - visit our shop!

ERIC / Constipation and Soiling / Info for Professionals /

Info for Professionals

Constipation with no anatomical or physiological cause is termed 'idiopathic'.

It is not uncommon and affects up to 30% of children, without early diagnosis and treatment it can become a chronic condition that is difficult to resolve.

One third of children suffering with idiopathic constipation may need referral to secondary care for the management of chronic constipation.

Associated symptoms include faecal soiling, irregular bowel activity, abdominal pain and poor appetite, all of which can have adverse effects on the child and family.

Children and parents often experience confusion, frustration and despair when they are confronted with this condition and may delay seeking help through embarrassment or fear of blame. It has also been suggested that the impact of constipation on children and families may be underestimated by some health professionals.

NICE have developed a guideline (CG99) 'Constipation in children and young people' based on best available evidence and offers strategies to support early diagnosis and timely and effective management. The aim is to provide a consistent and more co-ordinated approach and improve outcomes for children, young people and their families.

The guidance is invaluable to health professionals and includes useful tools and detailed information to enable health professionals to implement the recommendations.

The full and summary guidelines (CG99) are available to download from the NICE website.

If idiopathic constipation is not managed effectively it can develop into a chronic condition that can cause some distressing symptoms including faecal soiling, abdominal pain, irregular bowel movements and a general reduction in health and well-being.

Health professionals will be familiar with the effects this can have on children and know the frustration and despair experienced by families. Early detection and treatment will help reduce the effects on the child and family.

If not treated one third of children may need referral to secondary care due to chronic constipation that is more difficult to resolve.

The cost to families is also significant, not only in financial terms due to increased laundry and underwear costs, but also when social opportunities are spoilt by shame and embarrassment.

Parents and children sometimes feel that they are to blame, and fear that the problem will be seen as behavioural. As a result some parents have been reluctant to ask for help at an early stage.The ALSPAC (Avon Longitudinal Study of Parents and Children) research tells us that only one in three parents sought help for incontinence (Butler 2005).

The study also found significantly higher rates of behavioural and emotional problems, bullying and antisocial activities in children with faecal incontinence, compared to those without the problem (Joinson et al 2006).This view supersedes older research that implied emotional and behavioural issues were the cause of soiling rather than secondary to it (Joinson and Heron 2007).

An early multi-professional approach to the problem is likely to prevent any social and psychological consequences of coping with constipation and faecal incontinence into later childhood and adolescence (Clayden 2001).

NICE clinical guideline 99 'Constipation in children and young people' provides clear information and key recommendations for professional intervention.

References

Benninga M et al (2005) The Paris Consensus on Childhood Constipation Terminology (PACCT) Group. Journal of Paediatric Gastroenterology and Nutrition; 40: 3, 273-275.

Butler R, Golding J, Heron J and the ALSPAC Study team (2005) Nocturnal enuresis: a survey of parental coping strategies at 7.5 years. Child: Care, Health & Dev; 31(6): 659-667.

Farrell M et al (2003) Management of childhood constipation: parents experiences. Journal of Advanced Nursing; 44: 5, 479-89.

Clayden G (2001) The child who soils. Current Paediatrics; 11:130-134.

Joinson C, Heron J (2007) The Psychological Effects of Incontinence in Children. Continence UK; 1(3):59-63.

Joinson C, Heron J, Butler U, von Gontard A, and the Avon Longitudinal Study of Parents and Children Study Team (2006) Psychological Differences Between Children With and Without Soiling Problems. (ALSPAC study). Pediatrics; 117(5): 1575-1584.

NICE (2010) Constipation in children and young people. Diagnosis and management of idiopathic childhood constipation in primary and secondary care. www.nice.org.uk/guidance/CG99

Info for Professionals

Related products to buy