Reach out to children

‘Only a third of children with continence problems come forward for help,’ Ms Cheer says. ‘Most struggle on in silence because we don’t like to talk about continence and people often don’t recognise it as a medical problem.’ ‘A lot of constipation goes undiagnosed because parents think a child is soiling their pants because they are being lazy or slow, so there are a

NICE guidelines on constipation Many people do not recognise the signs and symptoms of constipation and few relate the presence of soiling to the condition, according to the NICE guidelines on constipation in children. The signs and symptoms of childhood idiopathic constipation include: infrequent bowel activity, foul smelling wind and stools, excessive flatulence, irregular stool texture, passing occasional enormous stools or frequent small pellets, withholding or straining, soiling or overflow, abdominal pain, distension, poor appetite, lack of energy, an unhappy, angry or irritable mood and general malaise. Without early diagnosis and treatment, an acute episode of constipation can lead to anal fissure and become chronic. Source: publications.nice.org.uk/constipation-in-children-and-youngpeople-cg99

NURSING STANDARD

lot of negative perceptions and ignorance around. But the vast majority of soiling is down to constipation.’ Ms Cheer says the pilot project in Bristol and South Gloucestershire aims to pick up continence problems at an earlier stage by focusing on points when all children will see healthcare staff, such as the two-year check-up by health visitors. Extra training on continence is being given to health visitors, child centre staff and local authority childminders, and leaflets on the issue is included in the information given to families. Ms Cheer, whose role with ERIC is part time, hopes to find a way to spread the lessons learned from the project across the country. ‘We need to reach out to every child. If we only look at those who have presented with problems, we are missing the two thirds of children who do not present. ‘So if early intervention is stressful, we need to find

out how to get it to other areas,’ she says. It is vital that children get the support they need, she adds. ‘Children with continence problems are not happy children. They have low self-esteem and poor academic achievement. It affects every aspect of their childhood and can have a lifelong impact. But the treatment, while not always being quick, is easy with the right level of support. Children do not need to suffer for years’ NS Find out more about ERIC at www.eric.org.uk

SUMMARY

One in 12 children and young people are affected by ongoing bladder or bowel problems that can have a devastating impact on their quality of life. The continence charity Education and Resources for Improving Childhood Continence (ERIC) is trying to improve access to services and treatments. Brenda Cheer, a paediatric specialist continence nurse, has been appointed by the Bristol charity to run a three-year Department of Health-funded project. She says that many families do not realise that their child has a medical condition that can be treated, and that even when they do seek help their GP may not respond in accordance with NICE guidance.

Brenda Cheer wants to dispel negative attitudes about childhood incontinence

STEPHEN LEWIS

A nurse-led project is helping children affected by bowel and bladder problems

A nurse-led pilot project in Bristol aimed at increasing early detection of continence problems in children is using routine health check-ups as opportunities for intervention. Author Erin Dean is a freelance journalist

may 7 :: vol 28 no 36 :: 2014  19

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