Pediatric Bowel Part II: How to Make Pooping Easier for your Kiddo

By Beyond Basics

Hey everyone! We are resuming our conversation about potty issues with kiddos. In our last blog, we discussed how issues with pooping can occur with kiddos and how often times it is easy to overlook long standing constipation in kiddos with fecal and urinary accidents. We learned that although it can seem like someone is doing something wrong, potty issues are no one’s fault. Even though poo problems are no ones fault, they are problems that families can work on together to be solved.

In this blog, we are going to discuss right here and right now what you can do today to help your child poop easier. Some of the changes are astonishingly simple while some may require a bit more work and change from the whole family. Keep in mind in order for anyone’s bowel to change ( not just kids), you must be consistent, and these changes may take a very long time to occur. Be patient, you and your child will get there. Let’s go over ways to get back on the right track now.

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STEPS to help with bowel issues:

Step 1: Allow your kiddo enough time to poop

Ever have to catch an early morning flight and noticed that you skip pooping that day, or even worse, you get a little bound up in the following week? Getting up early and rushing in the morning can constipate anyone and the thing is that’s what most kids are having to do. Many children have between half an hour to an hour to scarf down their food, dress, and brush their teeth before rolling out to school, leaving very little time to sit on the toilet and have an effective bowel movement. Kids then often find themselves at school with public bathrooms or single bathrooms within the classroom that don’t lock, making it hard to be comfortable enough to have a bowel movement. Then they usually must rush to extracurriculars and complete homework before bed. There simply is not enough time to poop.

Allowing your child 10-15 minutes to sit on the toilet 10-20 minutes after they eat can allow them to use what’s called the gastrocolic reflex. Basically what that means is when you eat, the body makes room for the new food by moving everything down further in the digestive canal. Therefore, after meals is the time when we are most likely to have a poop.

Allowing more time in the morning is the most easily modifiable part of your routine to start with when trying to improve your kiddos pooping habits. Get up about 30 minutes earlier to allow your child time to eat and to sit on the toilet. Follow with sitting on the toilet after lunch and after dinner.

Step 2: Fit the toilet to you child; don’t fit your child to the toilet

Studies show that toilet posture is imperative to good poops. My colleague, Sarah Paplanus, DPT, explains in detail the importance of having your knees above your hips while pooping in her blog on the squatty potty. Step stools will help your child get their knees above their hips, just remember to make sure that they keep their legs somewhat separated. Also, for the little littles, a child size toilet seat will help make sitting on the toilet more comfortable for kiddos with little tushes.

Also, check out this video on potty posture, with fellow peds therapist, Victoria LaManna PT, DPT, CLT

Step 3: Improve Diet

Most adults are aware that diet is important, but diet is equally as important with children. Making sure your child is getting enough fruits and veggies (approximately 5 servings daily), skipping sugary and refined foods like white bread, pastries, candy, and chips, and getting enough water (about half their weight in ounces) is so important to keep their stool soft and moving.

Step 4: Recognize Progress and Hard Work

Bowel issues are hard work for all involved. Make a sticker chart to track how often your child is compliant at sitting on the toilet, eating well, and having bowel movements. Make a goal for how many stickers your child will earn and celebrate when they achieve their goal. It is a long process so make sure to recognize even the smallest of victories.

Step 5: Get Help from Professionals

There is help out there. Make sure you go to a knowledgeable doctor and physical therapist to ensure your child gets the best chance at improving their bowel issues as quickly as possible. Do not accept any medical professional telling you it is normal for children to have accidents past potty training age, (age 5), or that it is your fault as a parent, or it is the child’s fault. It’s not. A knowledgeable doctor will run appropriate tests to rule out dietary allergies that could be contributing as well as starting your child on medicine or supplements to help improve bowel movements.

Pelvic floor physical therapy is a mainstay of care for kids with bowel issues, Skilled pediatric physical therapists will help your child re-learn how to use their pelvic muscles to better hold in waste as well as eliminate it when appropriate. We will teach you how to use techniques to help stool move more effectively, and we can perform hands on work to reduce pain and discomfort associated with bowel dysfunction. In addition to our clinical skills, we will help you to find doctors to help compliment the treatment your child is receiving in PT. If your child is suffering from bowel problems, don’t waste another day, call our front desk to make an appointment today!

Pelvic Floor Disorders and Treatment

— Beyond Basics PT | Pelvic Floor Therapy NYC.

Frequently Asked Questions

What is pelvic floor dysfunction and why does it happen?

Pelvic floor dysfunction is extremely common and occurs when the muscles, tissues, or nerves of the pelvic floor are weakened, tightened, or injured by trauma, chronic strain, or overuse. Pelvic floor disorders can result from traumatic injury such as a fall, from sporting activity, surgery, or childbirth. They can also happen from more chronic issues, such as infection or chronic inflammation such as endometriosis. Pelvic floor disorders can be a consequence of poor alignment or posture, overuse, or improper movement. The pelvic floor muscles surround the urethra, rectum, vagina and prostate; therefore, if there is a dysfunction in these muscles it can result in urinary, bowel, or sexual dysfunction in people of all ages.

Who should I see to get a proper diagnosis?

Many healthcare providers don’t assess – or don’t know how to assess – the pelvic floor muscles and nerves, so it’s important to get a proper diagnosis from a practitioner who specializes in pelvic floor dysfunction and pelvic pain. Too often patients tell us that they’ve been to 10 different doctors and healthcare providers and their symptoms have not improved, or have worsened. Find a specialist right away and get on the path to healing as quickly as possible.

Why do healthcare providers miss (or misdiagnose) pelvic floor dysfunction?

Long story short, the medical practice is divided into areas of the body: Urology. Orthopedics. Gynecology. But the body itself doesn’t have walls; every system interacts with everything else. Sometimes providers are so laser-focused on what they treat that they miss the whole picture. As more and more research emphasizes the importance of physical therapy as part of a complete treatment regimen, more and more physicians are learning how to recognize and treat pelvic floor disorder. In the meantime, if you’re not getting relief from your current treatment, make an appointment with a pelvic floor specialist to learn more.

How does pelvic floor dysfunction affect sex?

Pelvic floor muscles have a huge impact on sex. Muscles that are shortened or tight and are unable to elongate will not allow for good blood flow into the genitals. This can result in pain, weaker erections, diminished sensation, inability to orgasm, and even decreased lubrication. Pelvic floor PT can help with these issues by enhancing blood flow and improving muscle function.

How can pelvic floor dysfunction cause bloating?

Pelvic floor dysfunction, a condition characterized by the inability to correctly relax and coordinate pelvic floor muscles, can significantly contribute to bloating due to its impact on gastrointestinal functions. When these muscles are not functioning properly, it can impact the ease of emptying and make it difficult for your body to pass stool and gas through the intestines. This obstruction leads to an accumulation of waste and gas in the gastrointestinal tract, causing bloating and abdominal discomfort.

Is it true there’s internal massage?

There can be. We do perform internal soft tissue mobilization of the pelvic muscles that are inside your pelvis and are accessible only through the vagina or rectum. We never do internal treatment without your consent and understanding.

What makes someone a pelvic floor PT vs a regular PT?

All pelvic PTs get additional training in pelvic floor internal treatment through continuing education and at our clinic. We pride ourselves on the level of training we provide, not just at the beginning but throughout the time our therapists spend at Beyond Basics. We know that learning is a life-long process. We also provide additional training in physiology of the GI system and urinary system as well as sexual health and function and nutritional training. Most PT programs and schools do not provide the depth and breadth of knowledge that we provide all our PTs at Beyond Basics.

What are the first steps I should take if I suspect I have endometriosis?

If you suspect you have endometriosis, it’s important to schedule an appointment with a healthcare provider who specializes in endometriosis. They can help you determine the next steps, which often includes imaging tests, symptom management strategies, and a referral to a pelvic floor physical therapist.

How can pelvic floor physical therapy help with endometriosis symptoms?

Pelvic floor physical therapy can significantly alleviate symptoms of endometriosis by targeting the musculoskeletal system, which can help reduce abdominal-pelvic pain, bladder and bowel urgency, frequency, retention, incomplete emptying, and sexual pain. By addressing these areas, pelvic floor therapy can improve the quality of life for those affected by endometriosis.

How often should I attend pelvic floor physical therapy sessions?

The frequency of pelvic floor physical therapy sessions varies based on the severity of your symptoms and your individual treatment plan. Typically, patients might start with weekly sessions and gradually reduce frequency as they progress.

What can I expect during a pelvic floor physical therapy session?

During a pelvic floor physical therapy session, you can expect a thorough assessment of your pelvic floor muscles, a discussion of your symptoms, and personalized exercises to help relieve pain and improve function. Your physical therapist might also use techniques such as manual therapy, biofeedback, and relaxation exercises.

Are there any at-home exercises I can do to complement my pelvic floor physical therapy?

Yes, your physical therapist will likely recommend specific at-home exercises tailored to your needs. These might include stretches, relaxation techniques, and strengthening exercises to support your pelvic floor health.

How long does it take to see improvements from pelvic floor physical therapy?

The timeline for seeing improvements varies among individuals. Some patients might notice relief after a few sessions, while others may take several months to experience significant changes. Consistency with physical therapy and at-home exercises is key to achieving the best results.

How do I know if my pelvic floor muscles are contributing to my endometriosis pain?

A pelvic floor physical therapist can assess your pelvic floor muscles to determine if they are contributing to your pain. Symptoms such as pelvic pain, painful intercourse, urinary issues, and bowel dysfunction can indicate pelvic floor muscle involvement.

Can pelvic floor physical therapy replace surgery for endometriosis?

While pelvic floor physical therapy is highly beneficial for managing symptoms, it does not replace the need for surgical intervention in cases where excision surgery is required to remove endometrial tissue. However, in many cases, physical therapy can significantly reduce symptoms so that individuals might no longer need surgery.

Is pelvic floor physical therapy covered by insurance?

At Beyond Basics, we are out of network with most insurance providers. This allows us to offer better care, including full-hour, one-on-one sessions without passing you off to aides. We create a treatment plan based on your specific needs rather than the limitations set by insurance plans, and we focus on functional goals that truly improve your life. We accept out-of-network plans from Cigna, United Healthcare, Aetna, and Oxford. Our internal billing staff will work with you to submit claims on your behalf and walk you through your options. You can also make convenient monthly payments with various finance options through Care Credit, offering special interest-free financing of 6, 12, or 18 months, as well as discounted package rates. If you have any questions about insurance coverage or financing, call our billing office at 212.354.2622, text us at 212.354.2622, or email [email protected].

Should I get an assessment before doing Kegels?

Yes, it is important to get a proper assessment from a pelvic floor physical therapist before starting Kegels, especially if you’re experiencing symptoms such as pelvic pain, urinary issues, or discomfort. Not everyone benefits from Kegels, and doing them incorrectly or unnecessarily can lead to further issues. A personalized assessment will help determine the appropriate exercises based on your specific condition.

Why might Kegels not be beneficial for everyone?

Kegels are often recommended to strengthen the pelvic floor muscles. However, they’re not a one-size-fits-all solution and might not be suitable or beneficial for everyone. Some people have overactive or hypertonic pelvic floor muscles, and Kegels can exacerbate their symptoms. A personalized assessment is crucial to determine the right treatment approach.

What are some signs that Kegels might not be the right exercise for me?

If you experience more pain, discomfort, or pressure in your pelvic region after doing Kegels, it’s a red flag. It’s important to consult with a pelvic floor physical therapist to find the right exercises for your condition.

What alternatives to Kegels might be recommended by a pelvic floor physical therapist?

A pelvic floor physical therapist might recommend several alternatives to Kegels depending on the individual’s specific condition and needs. Alternatives to Kegels might include relaxation techniques, breathing exercises, postural correction, and manual therapy.

How can a pelvic floor physical therapist help me?

Our pelvic floor physical therapists can provide a thorough assessment of your pelvic floor muscles and tailor a treatment plan specific to your needs. They use various techniques to address pain, and dysfunction, helping you achieve better pelvic health and overall well-being.

Get help now from a pelvic floor therapist.

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