Elimination disorders in children have to do with the inability to control the emission of feces or urine at a time considered appropriate. The said problems correspond to a type of incontinence. However, in the present, it is not usually due to organic abnormalities.
Most commonly, elimination disorders in children resolve on their own over time. They almost always have to do with feebly adopted habits or touching circumstances that favor present behavior.
Also, elimination disorders may result from a chronic constipation problem, a very deep sleep cycle, or hereditary factors. In any case, it almost always manages to be overcome if they take appropriate measures.
What Are Elimination Disorders In Children?
We define Elimination disorders as difficulty controlling the sphincters during childhood. Now, the sphincters are ring-shaped muscles that open and close some voids in the body. Among them are those that give way to urine and feces.
The normal thing is that a child does not control the exclusion until after 18 months of life. From that age, he first begins to control the elimination of feces and then the urine. It completes the entire process between 3 and 5 years of age.
If there are difficulties in controlling the sphincters after age 5, we speak of elimination disorders in children. It is a common problem that is often not understood by parents. It can cause feelings of shame, low self-esteem, and isolation, among others in the child.
Types Of Elimination Disorders
There are two types of elimination disorders: urinary (enuresis) and fecal (encopresis). However, all of these types present some variants. Let’s see what each of these modalities comprises.
Enuresis is the passage of urine in bed or clothing in children five years or older. In order to fit into this category, there must be at least two episodes per week for a continuous span of three months. The problem should not be due to taking any medication or a medical condition, such as diabetes or others.
Enuresis can be daytime or nocturnal. Also, the elimination of urine can be voluntary or involuntary. It has estimation that 10% of children between the ages of 5 and 7 have this disorder. In addition, it is present in 3% of adolescents, 2 and 5% of young adults, and 0.5% of adults.
The other type of elimination disorder is encopresis. In this case, feces are evacuated on clothing or in inappropriate places such as the floor. In order to place it in this category, there must be at least one episode per week for three continuous months. It should not be the outcome of a medical substance.
There are two subtypes: constipated or non-constipated. It is estimated that between e. 1.5 and 7.5% of children suffer from encopresis. Doctors conduct about 3% of pediatric visits for this reason. The disorder is more often in boys than in girls.
Causes Of Elimination Disorders In Children
Almost all elimination disorders in children indeed have emotional causes. Cases in which the reason is physiological or anatomical are an exception. Also, a few times, medication or some substance causes this effect.
Most commonly, elimination disorders respond to a traumatic event or circumstance that causes anxiety and stress. This situation speaks of feelings of anguish and insecurity.
Entering school, conflicts with peers, the arrival of a sibling, conflicts between parents, a divorce, or the loss of a loved one are the causes of such issues in many cases. Furthermore, the cause may be behavioral or physical. Let us see.
If you may not train properly to the child to use the toilet, it will be difficult for the child. Perhaps they did not teach the child too early or too late, or they did not give clear instructions. Sometimes, the child does not want to interrupt his play and evacuates in an inopportune way.
Elimination disorders are also a common symptom of problems such as Oppositional Defiant Disorder or other behavior problems. Also, the little one may want to get his parents’ attention with this behavior.
Children with poor sleep patterns may have elimination disorders. They eat or drink for a moment before going to sleep. Further, sleep so deeply that they cannot wake up to go to the bathroom.
Some urological illnesses, cystitis, or a reduced bladder are factors that can provide an incline to enuresis. Certain neuromuscular, genitourinary, brain, or spinal cord problems may also cause elimination disorders. Chronic constipation frequently leads to uncontrolled bowel movements.
Elimination Disorders Treatments
Whenever there are elimination disorders in children, parents should consult the pediatrician so that he can evaluate the situation and indicate the path to follow. If the cause is physical, you will start the appropriate treatment to overcome the problem. If the origin is psychological, several therapies are available, such as the following.
Urine Alarm Therapy
In this case, they use and install humidity sensors in the bed. When moisture is detected, an audible or tactile alarm activates, alerting you to the bathroom. It corresponds to a behavioral conditioning mechanism. We expect the child to adapt to it and, at some point, stop needing the sensor.
Dry Bed Training
We should use the urine alarm also in this therapy, but there is a combination of other actions. For example, they must change the bedding if the child gets wet or dirty. Or he must stay awake for a while after wetting the bed.
Improved Potty Training
Here, the aim is to train the child to learn to control his sphincters correctly. The Child uses resources such as breathing techniques, contraction, relaxation of muscles, etc. The reward for Progress takes place with rewards to reinforce behavior.
There are also other methods to treat elimination disorders in children. Among them are the following:
- The parent must get up during the night to take the child to the bathroom and then return to bed.
- Parents encourage and tell the child to hold urination as long as possible. We intend to increase bladder retention.
- Using the Devices placed around the anus is important. Through these, the child can observe her muscular contractions in that area. It makes it easier for him to learn anal sphincter control.
- Child psychotherapy can help identify the situations that may be causing anxiety or fear in children.