The Role of Bowel Management in Children with Bladder and Bowel Dysfunction

Abstract

Bladder and bowel dysfunction is a common pediatric disorder that involves lower urinary tract symptoms (LUTS) as well as constipation and/or encopresis. Effective treatment of constipation in these patients leads to resolution or improvement of urinary symptoms in the majority of cases. Because many of these children initially present to the urologist with the primary complaint of LUTS, it is important for the consulting specialist to be well-versed on the topic of constipation. This review aims to provide an evidence-based guide on the evaluation and management of constipation in children. Recent papers have improved our knowledge on the utilization of interventions such as antegrade continence enemas and sacral nerve stimulation for more recalcitrant cases of constipation. Although there have been limited advancements in the use of pharmacologic therapies for the treatment of constipation in children, it is hoped that newer therapeutic agents proven effective for adult constipation will gain pediatric use over time. Present therapy for constipation in BBD is effective for the majority of patients. There is promise for further improvement in treatment options in the near future.