A big weekend for us as we had one of the world's leading paediatric & adolescent bowel / bladder physios travel from the USA to do some additional specialist training with us. We are one of the only physio clinics in the UK who already see children & teens with constipation, bed wetting, toileting anxiety, sports related urinary leakage, ADHD and autism related bowel/ bladder disorders & adolescent pelvic pain. Following Dr Carina Siracusa’s visit from Ohio we will now deliver this speciality in our 3 clinics.
It's a big undertaking having experts fly over from The States but we are keen to do everything to ensure the families from our communities get the best possible care.
Who do we see?
The young children we see in the clinic mainly are those with constipation which has been investigated by their family GP or one of our great local paediatric consultants. Parents or carers seek us out when the constipation starts to impact on school or on sports and activities that their child used to enjoy or is having problems starting with.
We also see children who are constipated but are also having some distressing soiling of underwear or problems getting clean post toilet or may be leaking some stool. Continuously having to change underwear or staining of underwear is a big give away that all is not well. We also see kids who are "stool hoarding" who may be having a bowel movement only every 2-3 days which is large, painful and very distressing. Hoarding Slyvanians or Thomas engines is fine but stools is not.
We also see lots of young children with bed wetting who may have already had specialist urodynamic testing that has shown reassuringly but frustratingly that everything is ok even though it's not. We see these kids when often there is a change whereby the bed wetting returns, gets worse or the child is starting to embark on sleep overs but can't due to their bed wetting.
We also see lots of children and young teens with Attention Deficit Hyperactivity Disorder ( ADHD) and children and teens on the autism spectrum who have constipation, toileting anxiety , bowel and bladder problems that are starting to really impact on the normal things they want to do and enjoy.
We have brilliant sports physios in our clinics so we already see a lot of young active children, the ones that get seen by our adolescent bowel and bladder physios are those who have some urinary symptoms with sport and these are both boys and girls who leak with sport. Some of our older boys may have had some trauma to the testicular or pelvic areas especially with football and rugby or we may see them post- surgery in that region. Some of our older teenage girls see us for early onset pelvic pain which may be menstrual cycle related or early onset endometriosis.
What does the assessment consist of and what questions will we ask?
A little bit like a normal physio assessment we will ask questions about what your child enjoys doing, what’s a normal week like for them, how active they are, what their home and school routine is like, what is their diet and fluid intake like and how annoying their siblings are!! What are their bowel and bladder habits and how this is affecting them (we are very skilled at asking these to mum, Dad or carer and their child in a sensitive & fun way). Mainly and most importantly what does your child think is going on and how is affecting them and what do they want to happen?
What tests will you do?
Things we will look at are their balance, strength, co-ordination, posture, walking (things that would happen at a normal physio appointment). We may ask you and your child to keep a bladder and bowel diary, like an excel file for your wee, poo, food and drink. If we have to look at their pelvic floor function we will do that by putting an Ultrasound probe on their lower tummy and they can see their bladder on the screen, boys in particular like this. This allows us to see if their pelvic floor muscles and abdominal muscles are doing what they should be doing. The ultrasound is fun and we get them holding the probe to get them involved.
I’m not sure if my child should see you or not?
Like all of our other patients please feel free to drop us an email (firstname.lastname@example.org ) or ring us on 0121 2709480 and one of our great physios will speak with you or communicate via email if this is easier. Lisa, Sundeep, Alina & Gerard are here to help you, your child and your family enjoy life a little better without being so toilet focused. Not only are they all very specialist physios but they are all parents themselves and know that if you help a child you help a household.