Bladder and bowel dysfunctions in 1748 children referred to pelvic physiotherapy: clinical characteristics and locomotor problems in primary, secondary, and tertiary healthcare settings

Abstract

The aims of this study are to evaluate in a pragmatic cross-sectional study, the clinical characteristics of childhood bladder and/or bowel dysfunctions (CBBD) and locomotor problems in the primary through tertiary health care setting. It was hypothesized that problems would increase, going from primary to tertiary healthcare. Data were retrieved from patient-records of children (1–16 years) presenting with CBBD and visiting pelvic physiotherapists. Prevalence’s of dysfunctions were compared between healthcare settings and gender using ANOVA and chi-square test. Agreement between physicians’ diagnoses and parent-reported symptoms was evaluated (Cohen’s Kappa). One thousand seventy hundred forty-eight children (mean age 7.7 years [SD 2.9], 48.9% boys) were included. Daytime urinary incontinence (P = 0.039) and enuresis (P < 0.001) were more diagnosed in primary healthcare, whereas constipation (P < 0.001) and abdominal pain (P = 0.009) increased from primary to tertiary healthcare. All parent-reported symptoms occurred more frequently than indicated by the physicians. Poor agreement between physicians’ diagnoses and parent-reported symptoms was found (k = 0.16). Locomotor problems prevailed in all healthcare settings, motor skills (P = 0.041) and core stability (P = 0.015) significantly more in tertiary healthcare. Conclusions: Constipation and abdominal pain (physicians’ diagnoses) and the parent-reported symptoms hard stools and bloating increased from primary to tertiary healthcare. Discrepancies exist between the prevalence’s of physicians’ diagnoses and parent-reported symptoms. Locomotor problems predominate in all healthcare settings. What is Known: • Childhood bladder and/or bowel dysfunctions (CCBD) are common. • Particularly tertiary healthcare characteristics of CBBD are available What is New: • Characteristics of CBBD referred to pelvic physiotherapy are comparable in primary, secondary, and tertiary healthcare settings. • Concomitant CBBD appeared to be more prevalent than earlier reported. • Discrepancies exist between referring physicians’ diagnoses and parent-reported symptoms.

The not‐so‐rare absent RAIR: Internal anal sphincter achalasia in a review of 1072 children with constipation undergoing high‐resolution anorectal manometry

“…Withholding behavior is known to be a major contributing factor to the development of constipation and is especially seen in younger children. [22][23][24] At follow-up, the majority of patients diagnosed with IASA (54%) were only using oral laxatives to treat their constipation.…”

“…These differences may have resulted from the smaller and younger control group Ciamarra et al used. Withholding behavior is known to be a major contributing factor to the development of constipation and is especially seen in younger children 22–24 …”

Physiotherapie bei kolorektalen Erkrankungen des Kindes- und Jugendalters

“…2013 wurde erstmalig über den Einsatz von physiotherapeutischen Behandlungstechniken zur Therapie von kolorektalen Funktionsstörungen berichtet (5). Ziel dieses Artikels ist es, über unsere Erfahrungen mit dieser Therapieform zu berichten mit besonderem Fokus auf die praktischen physiotherapeutischen Aspekte (6)(7)(8).…”

Neuromodulación por electroestimulación del nervio tibial para el tratamiento de enuresis: estado actual

“…(1) Es un problema de salud pública que disminuye notablemente la calidad de vida de quien la padece. (2,3) La enuresis es la incontinencia urinaria que ocurre en niños de al menos 5 años de edad, (4,5) con una prevalencia a nivel mundial de 5% a 15%, (6,7) y en México de 4% al 7%. (8,9) La prevalencia es mayor en niños (10.7%) que en niñas (5.4)%, (10,11) y disminuye un 15% por año conforme crecen.…”