Interdisciplinary Occupational and Physical Therapy Approach to Treating Constipation and Fecal Incontinence in Children

Abstract

Aims

This case series was completed to determine the effectiveness of an interdisciplinary (occupational and physical therapy) approach to treating constipation and fecal incontinence in children. Non-pharmacological therapies for treating constipation and incontinence are showing potential benefits, especially for children not responding to standard medical treatment, which involves oral laxatives for fecal dis-impaction (cleanout) and maintenance dosing to prevent further impaction.

Methods

A retrospective chart review, surface electromyography (sEMG) biofeedback, and parent and child reports of progress was completed for two children ages 4 and 10 years old. Progress toward goals was measured using a therapy plan of care and progress updates every 60 days. Focus of goals included, pelvic floor muscle coordination and activation, education of anatomy and physiology of digestive system, emotional regulation, functional training in the bathroom, and hygiene.

Results

Notable improvements in pelvic floor function, emotional regulation, and defecation dynamics contributed to decreased constipation and fecal incontinence as well as improved emotional regulation and confidence in both participants over a 6-month period.

Conclusion

A coordinated physical therapy and occupational therapy approach to treating children with constipation and fecal incontinence can be successful in reaching full continence and support children have not responded to standard medical treatment.

Keywords:

• Constipation
• coordinated approach
• fecal incontinence
• interdisciplinary
• non-pharmacological therapies
• interdisciplinary
• pelvic floor

Acknowledgments

Thank you to LaDonna Bannach at Beyond Boundaries Therapy Services for supporting pediatric research and for the families and children who participated in this case series.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Table 1. Child #1 Interventions.

Table 2. Child #1 Outcomes.

Table 3. Child #2 Interventions.

Table 4. Child #2 Outcomes.

Notes on contributors

Holly Osborn received her Masters of Occupational Therapy degree from the University of North Dakota in 2008. Holly was trained in Pediatric Incontinence and Pelvic Floor Dysfunction through Herman and Wallace Institute, and her research interests include Pediatric Incontinence and Rett Syndrome.

Stacey Reek received her DPT in 2017 from the University of Jamestown's Physical Therapy Program in Fargo, ND. She also acquired her Master's in Exercise Physiology through the College of St. Scholastica in 2014. Dr. Reeks was trained in Pediatric Incontinence and Pelvic Floor Dysfunction through Herman and Wallace Institute and her research interests include Pediatric Incontinence.

Brittany Anderson attended the University of North Dakota where she earned her Doctorate in Physical Therapy in 2008. Her research interests include pediatric incontinence, self-efficacy in pediatrics, and 3D printing adapted devices in pediatrics.

Additional information

Funding

There was no financial support other than the salaries of the investigators.

There was no financial support other than the salaries of the investigators.