Kids’ incontinence may affect psyche, behavior

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Children who have soiling problems are more likely than their peers to have a range of behavioral and emotional difficulties, new research shows.

In a study of more than 8,200 British children ages 7 and 8, researchers found that those with fecal incontinence were more likely to have attention-deficit hyperactivity disorder, anxiety, obsessive-compulsive behavior and conduct problems like oppositional-defiant disorder.

They were also more likely than their peers to either be victims of bullying or be bullies themselves.

The findings, published in the journal Pediatrics, show that children with soiling problems often have psychological difficulties. It’s not clear, though, which problems come first, according to the study authors, led by Dr. Carol Joinson of the University of Bristol.

In general, fecal incontinence in older children is often related to constipation. Still, Joinson and her colleagues write, it’s likely that a complex mix of dietary, genetic, biological and psychological factors also come into play.

The bottom line for parents, Joinson told Reuters Health, is that they should seek help for their children’s incontinence early on.

“Although soiling is a common childhood problem causing a great deal of distress to children and their families, little publicity is given to the problem,” she said.

As a result, Joinson added, many parents are unaware that soiling is a problem they should bring to their pediatrician’s attention.

The study included 8,242 7- and 8-year-olds who were part of a larger project on child health and development. The children were interviewed about their behavior, friends, self-esteem and bullying, and their parents completed questionnaires on a range of childhood behavioral and emotional problems.

Based on parents’ reports, about 1 percent of the children soiled themselves once a week or more, while another 5 percent did so less frequently.

Children in both of these groups also had more behavioral and emotional symptoms, but those who soiled frequently were particularly at risk.

About 20 percent of the children with frequent incontinence had some developmental delay, compared with only 7 percent of kids with milder soiling problems and 3 percent of those without incontinence.

But even with this difference taken into account, soiling problems themselves were still associated with behavioral and emotional difficulties, the researchers report.

Because constipation commonly underlies children’s soiling, Joinson said, treating that problem can often ease any psychological difficulties a child has. The current findings, she noted, underscore the importance of tackling soiling problems sooner rather than later.

SOURCE: Pediatrics, May 2006. 

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