Rationale and Comments
The association of lower urinary tract dysfunction and constipation is termed bladder-bowel dysfunction. Of children with function constipation, 25% to 30% have daytime urinary incontinence. Treatment of constipation alone can eliminate daytime urinary incontinence in many patients. It has also been shown to reduce recurrent UTI. The clinical diagnosis of constipation can be made using the Rome IV criteria. Treatment strategies involve education, fecal disimpaction in many, prevention of re-accumulation with maintenance regimens, and close follow-up. If a child is started on anti-cholinergic medications, the bowel regimen must be continued to obviate worsening constipation.
- American Academy of Pediatrics - Section on Urology
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