Elimination Disorder In Children

Elimination disorders in children are diagnosed either when a child does not accomplish control over their bowels and bladder within a reasonable expected time frame or if there has been a regression in this. For instance, a child may begin bed wetting or soiling their pants at the age of 7 or 8 after a difficult time in their life. The absence of the expected bowel and bladder control in development should be first explored medically. There can be a number of medical explanations for a child not accomplishing continence. Urinary tract infections or disorders may inhibit the child becoming dry during the day or night. Also, some medical reasons may impede the child from developing mastery over their bowels. The most troublesome elimination disordered is diurnal encopresis. The child soils themselves during the day. This results in peer alienation, shame, humiliation and family stress. It becomes critical to rule out medical explanations for this phenomenon as treatment begins. Children who exhibit this disorder for purely psychological reasons are involved with a vicious cycle. They view their elimination as a negative and thoroughly bad phenomenon, They unconsciously resolve to improve by stopping their elimination all together. They retain their feces in order to feel better about themselves. The next time they relax which is typically between 3:00-4:00 pm they have a spontaneous irresistible bowel movement and the cycle begins again. The counselor works in concert with the family and the pediatrician as they are working with the child. The child is assisted in accepting themselves and their own feelings while the families are guided to decrease pressure on the child. The pediatrician manages a medical regime that keeps the child’s stools soft and the colon evacuated. This systemic approach is the most one to succeed with this child.

The most commonly occurring elimination disorder is nocturnal enuresis (bedwetting). This can occur for a number of reasons. It has been associated with various forms of trauma. It is also frequently indicative of a seizure disorder. It also may be related to a medical problem. Most commonly however, it runs in families. It may not end until the age of 12-15 years old. When it occurs as a genetically endowed disorder, it is not effected by counseling. Rather, dry sleep hygiene is recommended. The pediatrician should be consulted.

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