Urology

Stool retention and UTIs

The function of the bowels is closely related to the function of the bladder. Many parents are surprised that treatment of urinary issues, such as urgency, frequency, urinary tract infections and enuresis includes a bowel management program. 

Constipation in children can often present differently than it does in adults. Many providers use the term “stool retention” to more accurately describe this condition. (More here on simple constipation and its treatment »)

Because children, especially young children, are often busy with play and activities, they frequently delay having a bowel movement. They quickly learn after toilet training that this delay in going to the toilet often causes the bowel-movement urge to fade away. And when they do go to the bathroom to have a bowel movement, they do not stay there long enough. They eliminate enough to relieve themselves, but not enough to empty the rectum. This results in a gradual accumulation of stool in the bowel, which stretches to accommodate the increased volume.

Children who delay having a bowel movement develop a pattern of “holding” the pelvic floor muscles and the urinary sphincter. This sensation becomes so common that they do not even realize they are doing it.  As a result, they become unable to relax the pelvic floor. This can lead to problems recognizing when the bladder and the bowel need to empty. Misinterpretation of these signals can contribute to urgency, frequency and daytime wetting accidents. The chronic holding can also affect the flow of urine out of the body, contributing to urinary tract infections. 

A history of large or infrequent bowel movements may indicate constipation or stool retention. But a child may have a bowel movement every day and still have a large amount of retained stool in the colon. Often an x-ray of the abdomen (known as a KUB)is done to look at the amount of stool and dilation in the colon. 

Content last reviewed: April 2010