Saturday 5 December 2015

Bladder Control - Getting up from the supper table to pee

Many parents presume that when a child leaves the supper table to pee that this has nothing to do with a full bladder. Parents often believe this behaviour is a tactic to avoid eating either because the child would rather play or because the child does not prefer to eat the food offered. The behaviour can infuriate some parents, especially when the child does this on a regular basis.

These children really need to pee. To the child, at that moment, the bladder does suddenly feel full.

Every time we eat, even a modest amount, the food lands in the stomach, and this initiates the Gastro-colic Reflex. This basic and automatic reflex makes perfect sense. When the food we eat enters the stomach, the brain instructs the bowel to contract and to move the previously ingested food lower down in the intestine to make room for the next meal.

Down at the bottom of the intestinal tract, the muscles in the descending colon and rectum contract and push the poop in this location deeper into the pelvis.

The bladder is located at the bottom of the funnel-shaped pelvis where there is the least available room. When the poop in the rectum pushes on the bladder, the increase in bladder pressure is recognised as a signal to pee. The signal is actually a signal to poop and pee, but most often the child leaves the table and only pees.

To minimise this behaviour the parent should instruct the child to pee before they sit down to the dinner table. A trip to the bathroom to wash the hands before dinner is an important personal hygiene behaviour. If the child pees first, washes their hands, and then sits down, getting up from the table to pee can be avoided.

The get-up-from-the-supper-table-to-pee behaviour is also a clue that the bowel health needs to improve. This behaviour is much less common in children who have a poop after breakfast because there is less poop hanging out at suppertime to press on the bladder. This behaviour is much less common in children who have soft poop because the impact of soft poop on the bladder is very different compared to the impact of hard or pasty poop. 






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