Pediatrics and Pelvic Health: Chronic UTIs, Bowel and Bladder Dysfunction

Frequent Urinary Tract Infections (UTIs) in children can be closely tied to bowel and bladder dysfunctions

According to the International Children’s Continence Society, frequent urinary tract infections (UTI) in children can be closely tied to bowel and bladder dysfunctions, which are closely tied to pelvic floor dysfunction.

UTIs can signal different things for infants vs. older kids

When UTIs occur in babies, it can be a sign of an anatomical issue which has to be diagnosed via imaging and treated sometimes with surgical correction. If your child is 3 years of age or younger and often suffers from UTIs, it is important to seek care from a pediatric specialist to rule out anatomical issues so that they can get appropriate care.

Older kids who suffer from frequent UTIs may have issues with their bladder or bowel. These issues can include incomplete bladder emptying and functional constipation. Again, it is important to seek the care of a pediatric specialist who can screen for these issues and diagnose them properly.  

Treatment for Bowel and Bladder Dysfunctions

Ideally, your child with a bowel or bladder dysfunction will be under the care of a multidisciplinary healthcare team. A team made be made up of pediatric subspecialists, an urologist, gastroenterologist, psychology professional, and pelvic floor physical therapist with pediatric training.

How Pelvic Floor Physical Therapy Can Help

The therapists at Fusion Wellness and Physical Therapy/Femina Physical Therapy can help your child heal from their bowel or bladder dysfunctions and gain good skills and behaviors around toileting which will help them their entire life.

Our pediatric protocol is minimally invasive and involves a lot of patient and parent education. We typically do not do internal examinations or interventions until all external options have been exhausted.

What types of treatments you can expect with pediatric pelvic floor therapy:

Behavioral Modification

• We will teach both child and parent about healthy toileting habits, including diet, scheduling, and body mechanics (yes, there is a RIGHT way to poop and a WRONG way to poop).

Biofeedback

• Using special biofeedback software and equipment, we will teach your child how to relax their pelvic floor and improve their urinary and bowel evacuation.

Therapeutic Exercises

• We will teach your kiddo a variety of exercises to strengthen and stretch the pelvic floor muscles so they can feel confident in their ability to control both bowel and bladder issues.

Neuromuscular Re-Education

• We will help your kid’s brain and muscles coordinate correctly so that you are actually relaxing your muscles when you think you are relaxing them.
• 40% of people with constipation have a muscle coordination issue where they are actually squeezing their pelvic floor muscles when they think they are relaxing them. This issue is calleddyssynergic defecation, read more about it at the Femina Blog.

Toileting ergonomics

• Believe it or not, there is a right way and a wrong way to poop. Our therapists have kid friendly ways of teaching the skills of successful pooping that your kiddo will have for the rest of their lives

Relaxation and Breathing Exercises

• In order to have a bowel movement, the body must relax the anal sphincters and pelvic floor muscles. At the same time, the body must create enough over pressure to help facilitate the evacuation. Using breathing and relaxation exercises, we will teach your kid how to master these techniques.

Abdominal massage

• Taught to parents and child, tummy massage techniques facilitate bowel movement

Myofascial Release

• Using manual therapy to address abdominal and pelvic girdle muscles that can be tight or in spasm, causing poor function of these muscle groups.

The ultimate goal is to help the child to be able to fully relax the pelvic floor and have a complete bowel movement without strain or pain.

Give the therapists at Fusion Wellness and Physical Therapy a call today! (818) 864-6732

Resources

Koff SA, Wagner TT, Jayanthi VR (1998) The relationship among dysfunctional elimination syndromes, primary vesicoureteral reflux and urinary tract infections in children. J Urol 160:1019–1022

Giurici N, Pennesi M (2012) Importance of bladder bowel dysfunction in patients with urinary tract infection. J Pediatr 161:370

Yang S, Chua ME, Bauer S, et al. Diagnosis and management of bladder bowel dysfunction in children with urinary tract infections: a position statement from the International Children's Continence Society. Pediatric Nephrology (Berlin, Germany). 2018 Dec;33(12):2207-2219. DOI: 10.1007/s00467-017-3799-9.

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