Encopresis 

Conditions We Specialize In for Pediatrics: 

Childhood constipation is typically due to a protection response from experiencing a painful bowel movement that prompted the child to voluntarily withhold stool. Children will resist the urge to go by hiding in the corner, rocking back and forth and/or demonstrating facial grimaces when experiencing the urge to pass a bowel movement. Treatment for childhood constipation with pelvic floor therapy would consist of fully understanding the child’s typical toileting habits through a bowel diary and conversations with parent/guardian, bowel education, implementing various movement patterns/exercises to build strength and coordination, biofeedback for coordination and support through multidisciplinary collaboration regarding dietary and lifestyle contributors.

Constipation

Involuntary leakage of feces, most commonly caused by chronic constipation in children older than the age of four. Treating encopresis with pelvic floor therapy would consist of addressing a child’s toileting habits/behaviors, bowel education, building muscle coordination/strength, and familial support. 

Enuresis (Bedwetting): 

Voiding Dysfunction & Daytime Leakage: 

Unexplained Pain & Functional Limitations

Children may experience pain in the abdomen, spine or hip that may not have a specific pathology. This can be related to posture, tone, bowel/bladder dysfunction and could impact their overall function and day to day activities. This may be related to other developmental concerns including toe walking, gross and fine motor delays, and "W" sitting that persists past age 5. Treatment would consist of education, posture, coordination, strength and providing familial support. Our focus as pediatric pelvic floor therapists would be addressing co-existing bowel/bladder dysfunction that is commonly related to all above while promoting independence with toileting and self management. 

Children may have difficulty emptying their bladder, possible resulting in daily leakage, urinary urgency/frequency while at school and pain or straining with urination. Voiding dysfunction is commonly seen in children above the age of 6. Treatment would consist of tracking a child’s typical bladder habits through a bladder diary, addressing behavioral and emotional barriers, and building strength and coordination in the muscles of the core, pelvic floor and hips. 

Enuresis, also known as Bedwetting, occurs when a child involuntarily releases their bladder at night due to muscle tension, weakness or incoordination within the pelvic floor. This is commonly addressed in children above the age of six. Treatment will consist of gathering an in depth understanding of a child’s daytime voiding pattern, toilet training history, sleeping habits, water/nutrient intake and behavior, personality and emotional status through conversations with child and family.