When Your Child Has an Elimination Dysfunction

Your child has been diagnosed with an elimination dysfunction. Many children develop these problems during or after potty-training age. Your healthcare provider will tell you more about options for treating or managing the problem.

Elimination problems can occur when a child holds in stool or urine too long. A too-full rectum pushes against the bladder, causing wetting accidents.

What Is an Elimination Dysfunction?

It is a problem holding or releasing urine or stool. Infants release (eliminate) urine or stool by reflex. As a child gets older, he or she learns to control these functions. If a child has a problem controlling the release of urine or stool, it’s called an elimination dysfunction.

What Causes Elimination Dysfunction?

In most cases, an elimination dysfunction occurs because a child holds in urine or stool too long. Children may put off using the bathroom because they don’t want to stop an activity. This puts them at risk of wetting or soiling accidents. It can also lead to the inability to release stool. This is called constipation.

What Are the Signs?

• Involuntary release of urine (incontinence) during the day or nighttime

• Constipation

• Problems with urine flow, such as trouble starting, weak flow, or a lot of starting and stopping

• Infrequent or frequent release of urine (voiding)

• Painful urination

• Urinary tract infection

• Low-back, belly (abdominal), or side (flank) pain

How Is an Elimination Dysfunction Diagnosed?

Your healthcare provider will ask you about your child’s health. A physical exam will also be done to look for problems. To help get more information:

• You may be asked to keep a record of your child’s elimination habits.

• A renal (kidney) ultrasound may be used to check for blockages in the urinary tract and swelling of the kidneys.

• A urodynamics study may be done to give the healthcare provider a detailed look at how well your child’s bladder and urethra work.

How Is an Elimination Dysfunction Treated?

Treatment depends on the cause, type, and severity of the problem. Your child may need one or more of the following treatments:

• Behavioral therapy helps your child change his or her elimination patterns. This may also include some or all of the following:

  • Timed voiding, which means emptying the bladder regularly to help avoid urination accidents.

  • Managing when and how much fluid your child drinks.

  • Positive reinforcement techniques.

• Biofeedback therapy helps your child locate and learn to relax the muscles used to control urination.

• Medication helps relax the bladder if needed.

• Intermittent catheterization drains the bladder on a regular schedule. It involves inserting and removing a tube (catheter) through the urethra into the bladder each time it needs to be emptied. This treatment is used in severe cases.

What Are the Long-Term Concerns?

With proper management and behavior changes, there are usually no long-term problems. However, incontinence can sometimes lead to embarrassing moments and self-esteem issues. Talk to your child’s healthcare provider about any concerns you have about this.