Bladder-Bowel Dysfunction in Children: Consequences, Risk Factors and Recommendations for Primary Care Interventions

Abstract

The goals of this paper are to review potential risk factors and emerging insights into nature of bladder-bowel dysfunction (BBD) and highlight a patient-centered approach to management, which can begin in the primary care setting. (1) BBD is documented in about half of patients with vesicoureteral reflux and increases potential for renal scarring. (2) Neurodevelopmental and environmental factors are associated with BBD and greater understanding of a neurocentric basis for BBD is emerging. (3) A patient-centered approach to care is required. The way in which children and adolescents understand their bladder, bowel, or continence problem can influence coping strategies and adherence to treatment. Early identification and treatment of BBD is important to prevent significant medical and social burden. The primary care provider with foundational knowledge of the causes and risk factors for BBD and an established relationship with a patient and family is well suited to identify BBD and begin management.