Disclaimer :: Woerner Physical Therapy sponsored and wrote the content for this post to provide Fort Worth Moms readers with information on pelvic health and physical therapy.
Does your child experience constipation, pain with bowel movements, or frequent abdominal pain? Most moms are told the answer to constipation in children is prune juice or prescription medication, but what if that is not the only answer? What if your child could potentially have regular bowel movements and less discomfort with minimal to no use of medication?
According to the American Academy of Family Physicians, three to five percent of primary care visits and 25 percent of gastroenterology visits are to address constipation.
Ideally, your child should have a bowel movement one to three times per day, at minimum once every other day. Other signs of constipation can be urinary or fecal incontinence.
We do not always think about children having issues that are common among adults, but they do! They have the same organ systems and muscles that adults do, just on a smaller scale.
The abdominal cavity is filled with organs, muscle, and connective tissue. The base of the pelvis consists of a bowl of muscle and connective tissue. These muscles help support all of the pelvic organs, including the bladder, colon, and uterus, in addition to helping stop and start the flow of urine, gas, and stool. If there is dysfunction with connective tissue or muscle in the abdomen or pelvis, the quality of stool and effectiveness of bowel movements can be impacted.
While managing the symptoms as needed is completely appropriate, it is important to determine the root cause of constipation to avoid further dysfunction down the line. Many children who suffer from constipation early on in their lives continue to face the problem in the future. Furthermore, some may develop chronic abdominal pain or lower back pain as a teenager or young adult.
Many people do not consider the possibility that there are other ways to change the quality of stool in addition to medication. It can involve many other methods, which is why it can be so beneficial to have a physical therapist on board to look at the condition from a different perspective.
When seeing a child for constipation, it is vital to look at the body as a whole. It is important to assess a child’s diet, bowel and bladder habits, and activity level in addition to the abdominal and pelvic muscle function and connective tissue mobility. After assessing these areas, an individualized plan is developed to address where dysfunctions or deficits are found. The treatment plan is always reviewed and explained in detail to the child and parent to make sure everyone is on the same page and comfortable with the treatment plan. Thankfully, most pediatric pelvic floor treatment in a physical therapy setting is non-invasive and not painful to the patient.
Although there are a multitude of treatment options, a few common ones include a bladder/bowel diary, biofeedback, manual therapy to the abdomen, and exercise. A bladder/bowel diary helps determine any trends or connections between what a child is eating, his or her symptoms, and the frequency and quality of voiding. These trends help determine any lifestyle modifications, such as diet changes or sleep patterns, that may need to occur to encourage appropriate function. Biofeedback uses surface electrodes to assess how a muscle group is functioning, in this case either the pelvic floor or the abdominal muscles. This information is used to help determine if the muscles are weak, overactive, or have difficulty coordinating themselves. Manual therapy is typically performed over the abdomen in pediatric cases, which encourages good gut movement and helps reduce any connective tissue restrictions present in the abdominal cavity. At the end of the session, the findings will be reviewed, and a home exercise program will be given to the parent and child to perform at home in order to improve symptoms and maintain progress.
Overall, pediatric pelvic floor physical therapy is a viable option for most children who struggle with constipation or other urinary and bowel disorders. Physical therapy can be a piece of the puzzle that helps resolve the root cause of the problem instead of simply addressing the symptoms.
Dr. Ball PT, DPT is a physical therapist at Woerner Physical Therapy who specializes in treating pelvic floor dysfunction in the pediatric and adult population. Her goal is to provide individualized, compassionate care to help her patients reach optimal function through functional movement, manual therapy techniques, neuromuscular re-education, and lifestyle modifications.