World Bedwetting Day It'Time to Take Action

New Hope for Children with Bedwetting, Constipation and Other Potty Problems

from

Pelvic Floor Trained Physical Therapists in Northern Virginia

World Bedwetting Day is May 29th 2018

The theme is: “Time to Take Action”!!

Alexandria & Lorton, VA -- New hope has arrived for children suffering from bedwetting, daytime wetting, constipation, and other bladder and bowel disorders. Specialty trained physical therapists in Northern Virginia are offering a new approach treatment that focuses on rehabilitating the pelvic floor muscles to overcome these embarrassing conditions.

World Bedwetting Day is May 29th and its sponsors International Children’s Continence Society (ICCS) and European Society for Pediatric Urology (ESPU) started this day in 2015 to bring awareness to bedwetting as a serious medical condition that should be treated.

Northern Virginia-based pelvic floor physical therapy pioneer Mary Nalls, PT, MPT, owner of Physical Therapy Your Way & Advanced Specialty Care, PLLC, and Back in Motion Physical Therapy, PLC, agrees. Nalls introduced pelvic floor physical therapy to Northern VA in 1991 and along with her staff of 10 other dedicated pelvic health physical therapists, has been treating adults with elimination and sexual disorders ever since. Nalls now wants to help spread the word about how this effective therapy can also benefit children.

Worldwide, it is estimated that more than 5 million children suffer from bedwetting, and 20% of visits to pediatrician offices are for urinary issues. Three percent of pediatrician visits are for constipation, which often accompanies urinary problems, says Nalls. Bedwetting is a common problem and may affect 1 in 15 seven year olds. In children age 5 years or over, enuresis is considered abnormal.

Bedwetting is caused by many factors including: overproduction of urine at and constipation. But what is currently missing in conventional treatment is the possible connection to impaired pelvic floor muscles, says Nalls. These muscles can be weak, tight or lack coordination, she says, and proper rehabilitation may help. It is a myth that bedwetting is caused by psychological disorders; however, these bladder and bowel conditions can have serious psychological effects on a child’s quality of life, cognition, social development, school performance and self esteem, says Nalls. These psychological effects usually reverse after successful treatment.

Traditional treatments for bedwetters include various medications including desmopressin, bed alarm systems, or waiting and hoping your child will outgrow these problems. However, “Waiting too long can result in chronic issues," says Steve J. Hodges, MD, pediatric urologist and author of, "It’s No Accident, Breakthrough Solutions to Your Child’s Wetting, Constipation, UTIs, and Other Potty Problems". "As children become adults they can end up with chronic pelvic pain, constipation and pain with sexual intercourse," Hodges says.

Postponing care can also lead to grave consequences, says Dawn Sandalcidi, PT, RCMT, BCB-PMD, a physical therapist and owner of Physical Therapy Specialists, a private practice in Centennial, Colorado. Sandalcidi is the leading expert in the field of pediatric incontinence in physical therapy. Her decision to focus her career as a pediatric pelvic floor therapist was facilitated by a call from a doctor who informed her of the death of an 11-year-old boy who hung himself after being ridiculed by his siblings and peers over episodes of fecal incontinence. The doctor told Sandalcidi, "If only that family had known about you. You could have taken care of him." Sandalcidi emphasizes not waiting for these children to outgrow this disorder.

These bowel & bladder disorders frequently occur from a vicious cycle of behaviors that contribute to one another. For starters, kids who are constipated frequently strain during a bowel movement which may lead to a painful experience and because they associate going to the bathroom with pain, they postpone. As a result of withholding, pelvic floor muscles can get tight, overstretched and weak.

Physical therapists specially trained in pelvic floor disorders emphasize that there are other ways to approach these problems. A physical therapist’s method to treatment is comprehensive and holistic. With a parent or caregiver present, an external evaluation of the child’s pelvic floor muscles and reflexes are tested. A full body movement screen is performed. Depending on the evaluation’s findings specific to each child, treatments may include: how to strengthen, relax, stretch or coordinate their pelvic floor or other muscles. Patients are educated on how these pelvic muscles are used to control their bowel and bladder problems.

An instrument called EMG Biofeedback may be utilized to measure and treat the dysfunctional pelvic floor muscles. During biofeedback treatment sessions the therapist may use interactive video games to train the children’s pelvic floor muscles in a format the children love.

Behavioral treatment strategies are also implemented. These may include bladder training, scheduled voiding, proper seating postures on the toilet, wiping techniques to avoid urinary tract infection, constipation tips, working with teachers & school nurses to schedule bathroom visits, dietary suggestions such as avoiding bladder irritants, proper hydration and other functional strategies.

Six to eight physical therapy sessions is typically the number of visits needed for improvement; however, Nalls says the key is not the number of visits but how consistent families and patients are with compliance with their tailored home program.

"So often, people blame the child like this condition is under his or her control, when in fact, it's not. We want kids, parents, and schools to know that these children aren’t doing this on purpose -- bedwetting is not anyone’s fault -- and there are effective conservative treatments available that need to be implemented without delay," Nalls says.

By including pelvic floor muscle rehabilitation, behavioral strategies and having doctors rule out urinary tract infections, structural abnormalities, and more, therapists and medical professionals can work together to help identify what is causing the problem and offer appropriate treatment. Since not many physical therapists specialize in this area and most physicians do not know we exist, we need to educate the medical community, parents and schools about this effective alternative. It’s time to take action, says Nalls.

Physical Therapy Your Way & Advanced Specialty Care has offices in Alexandria and Lorton, VA. Besides offering pediatric physical therapy for bladder and bowel issues, they treat both men and women with pelvic floor disorders, as well.

For more information, please visit www.PhysicalTherapyYourWay.net.

Maryn.BIM@gmail.com

Contact: Mary Nalls PT, MPT

571-312-6966

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References:

• https://www.ncbi.nlm.nih.gov/p...
• Sandalcidi, PT, RCMT, BCB-PMD
• ICCS International Children’s Continence Society,
• ESPU European Society of Pediatric Urology
• Steve J. Hodges, MD, Pediatric Urologist