Bowel Incontinence Care

What if a child has bowel incontinence?

A child with bowel incontinence who is toilet trained should see a health care provider, who can determine the cause and recommend treatment. bowel incontinence can occur in children because of a birth defect or disease, but in most cases it occurs because of constipation.

Children often develop constipation as a result of stool withholding. They may withhold stool because they are stressed about toilet training, embarrassed to use a public bathroom, do not want to interrupt playtime, or are fearful of having a painful or unpleasant bowel movement.

Similarly to adults, constipation in children can cause large, hard stools that get stuck in the rectum. Watery stool builds up behind the hard stool and may unexpectedly leak out, soiling a child's underwear. Parents often mistake this soiling as a sign of diarrhea.

Anal Discomfort

Steps that help relieve anal discomfort:

• Washing the anal area after a bowel movement. Washing with water, but not soap, can help prevent discomfort. Soap can dry out the skin, making discomfort worse. Ideally, the anal area should be washed in the shower with lukewarm water or in a sitz bath. No-rinse skin cleansers, such as Cavilon, are a good alternative. Wiping with toilet paper further irritates the skin and should be avoided. Premoistened, alcohol-free towelettes are a better choice.
• Keeping the anal area dry. The anal area should be allowed to air dry after washing. If time doesn't permit air drying, the anal area can be gently patted dry with a lint-free cloth.
• Creating a moisture barrier. A moisture barrier cream that contains ingredients such as dimethicone - a type of silicone - can help form a barrier between skin and stool. The anal area should be cleaned before applying barrier cream. Patients, however, should talk with their health care provider before using anal creams and ointments.
• Using nonmedicated powders. Nonmedicated talcum powder or cornstarch can also relieve anal discomfort.
• Using wicking pads or disposable underwear. Pads and disposable underwear with a wicking layer can pull moisture away from the skin.
• Wearing breathable clothes and underwear. Clothes and underwear should allow air to flow and keep skin dry. Tight clothes or plastic or rubber underwear that blocks air can worsen skin problems.
• Changing soiled underwear as soon as possible.

SOURCE:
NDDIC. Fecal Incontinence