1. Constipation and Soiling in Children
Karen Nelson / Sara-Jane Barlow
HNHSFT
Continence Advisory Service

2. Constipation and Soiling in Children
20 minutes
Presentation of symptoms
Initial appointment
Follow up / treatment options?
Referral on?

3. Constipation and Soiling in Children
Constipation and soiling “Soiled pants can be a sign of constipation, as runny poo (diarrhoea) may leak out around the hard, constipated poo. This is called overflow soiling”.

4. Constipation and Soiling in Children
Initial appointment - What is worth knowing at this appointment? Stool chart? Type / frequency of stools Medication Laxatives taken? What has been tried before? Actively question the patient

5. Constipation and Soiling in Children
What should you do at this appointment? Red flags? Fluids – types and amount Diet Toileting routine? Positioning? Stool chart to complete for review

6. Constipation and Soiling in Children
What should you do at this appointment? (GP) All of above – plus: - Abdominal examination – rule out constipation Neurological examination

7. Constipation and Soiling in Children
If you are prescribing medications – what do you want to achieve? Softeners / osmotic laxatives? Stimulant laxatives? Bulking agents? Practical advice: - Toilet plan / location; own cushion; spare clothing; wipes / pad; nappy sacks; perfume.

8. Constipation and Soiling in Children
Referral? Paediatrician? Continence Service? Management – dry like me

9. Constipation and Soiling in Children
Comments / Questions