Taboo topics with a Continence Clinician

Of all the topics to talk about, poo and wee may not be top of the list. But for Therapy Focus’ PEBBLES Team, your bathroom business is our business.

A key part of our job is removing the stigma around continence issues to help people seek support for even the most taboo topics. This article looks at some of the issues people find a little uncomfortable to talk about.

Faecal Incontinence

Did you know that 1-3% of children experience faecal soiling (aka pooing pants)? It is more common in boys but still happens to girls. Faecal incontinence is not caused by naughtiness, laziness or attention-seeking and punishing this behaviour can make it worse.

One major cause of faecal soiling in children is constipation, which can affect up to 25% of children. Treating constipation with timed toileting routines, fluids, dietary changes and appropriate medication can often resolve the faecal incontinence.

It’s not just children who experience faecal soiling either. In 2010, 1.3 million Australians aged 15 and older had faecal incontinence. In addition to constipation, other factors that can lead to faecal incontinence include:

• Long term straining
• Medications i.e. antibiotics and drugs for arthritis and diabetes
• Lifestyle factors i.e. heavy lifting leading to weak pelvic floor muscles
• Weak back passage muscles as a result of childbirth, ageing, some surgeries and radiation therapy
• Diabetes
• Bowel diseases such as Coeliac disease or Crohn’s disease
• Nerve disorders resulting from multiple sclerosis and Parkinson’s
• Severe diarrhoea

Faecal incontinence can be treated and should not be ignored. The first step is a comprehensive continence assessment by a health professional.

Faecal Smearing

Some children and adults engage in faecal smearing. This is the act of wiping faeces (poo) on themselves, clothing or other objects. Some possible reasons for faecal smearing are:

• Boredom with daily activities
• Seeking sensory stimulation with strong smells and messy textures
• Seeking attention associated with soiling
• Development of a persistent habit

Behavioural and sensory interventions can be effective in the management of faecal smearing. It is important to try to explore the reason for the smearing so that the most effective intervention is implemented.

Sexuality and Incontinence

Bladder or bowel incontinence can have an enormous effect on sexuality, however, this doesn’t mean that people with incontinence do not express their sexuality.

There are many ways that someone with bladder or bowel control issues can manage their symptoms and engage in sexual acts with their partner. More information about this can be found on the Continence Foundation of Australia’s website.

Therapy Focus’ specialist continence team, PEBBLES, provide assessment, treatment and advice for all of these topics, as well as for other bladder and bowel health-related issues.