Toileting troubles in teenagers and young people

Davina Richardson, RGN/RSCN Specialist Children’s Nurse at Bladder & Bowel UK, reminds us that toileting problems don’t just affect children and the elderly. She explains the different continence issues teenagers may experience, gives tips to try at home and where to get more support.

Many bodily functions are considered private and not for discussion.  Top of the list of the ‘not to be talked’ about is toileting!  Many people think that once a child has been toilet trained, their bladders and bowels will work for the rest of their lives.  If they do have problems in the future, these will not occur until old age. This myth is able to continue because so many of us are too embarrassed to discuss problems, even with the people we are closest to.  So those young people who do have a problem often don’t ask for help. 

What toileting problems may teenagers have?

Problems that teenagers may have with their bladder and bowels include:

• Frequency – having to go to the toilet for a pee more than seven times a day

• Urgency – having to get to the toilet in a hurry some or all of the time

• Wetting – when pee comes out on its own, usually with little or no warning

• Bedwetting – wetting during sleep. There may be other problems as well, or the bedwetting may just happen at night, with no pee or poo problems during the day

• Constipation – having a poo less than three times a week; having poos that are painful or difficult to pass; passing poos that are very large or very small; passing poos that are very sticky, or hard, or loose; having to strain to poo

• Soiling – when poo leaks into the underwear, either because it gives no warning it needs to come out or because you don’t know it is there

Many teenagers have more than one bladder or bowel problem. For example, those who wet the bed may also have frequency, urgency and daytime wetting and may be constipated.

What can I do to improve the situation?

• Drink plenty of water-based drinks, spaced evenly throughout the day (about 1 ½ – 2 litres per day for teenage girls and 2 – 3 litres a day for teenage boys, with more if the weather is hot, or you are doing lots of exercise):

This helps by making sure that pee remains weak (pale in colour).  Strong wee (dark in colour) is more likely to irritate the lining of your bladder, which makes wetting worse.  Being well hydrated helps to prevent constipation, which can cause problems with the bladder as well as the bowel.  Drinking well also helps to prevent urinary tract infections (UTI)

• Avoid drinks that contain caffeine (tea, coffee, hot chocolate and energy drinks). These not only make the kidneys produce more pee, but also irritate the bladder and therefore may make wetting worse

• Avoid drinking in the hour before bed, particularly if you have problems with bedwetting

• Avoid eating in the hour before bed if you have a problem with bedwetting and make sure you go to the toilet just before you go to sleep 

• Eat plenty of fruit and vegetables (five to seven portions a day). This helps prevent constipation

• Go to the toilet as soon as you feel the need

• Talk to someone about the problems (see below)

Can school help?

If you are having problems with your bladder or bowel, you should be able to get a medical pass to allow you out of lessons, so that you can go to the toilet as soon as you need to.  Most schools will provide a pass if they are aware of the problem.  You could ask your pastoral leader (e.g. head of house or head of year) or ask your parent or carer to speak to them.  You could ask your school nurse to arrange the pass for you.

You should be allowed to have a water bottle with you in school, so that you can drink regularly. If this is not allowed speak to your school nurse or talk to your school council.  If you are worried about the state of your school toilets, you and your friends could raise this as an issue with the school council.

What other help is there?

Some teenagers have toileting issues because of a medical condition they have been born with, or that has developed later, due to injury or illness.  They may need to use catheters or medicines or to have special bowel management programmes.  If this applies to you, then do follow the advice you have been given and if you are worried or struggling let your doctor or nurse know.

Life for teenagers is difficult.  There is a natural need to be or feel the same as everyone else.  If you had experienced ‘leaks’ when you were younger and were told off for this, because the adults looking after you thought you were being lazy or naughty, then you may be particularly worried about asking for help.  You should try not to be concerned about asking for help as there is a better understanding of the causes of these problems now.

At Bladder & Bowel UK we know that having a problem with your bladder and/or bowel (continence problems), causes distress to young people.  Feeling the need to hide such problems makes young people feel different and cut off from friends and social groups.  Continence problems, if discovered, might result in teasing or bullying. They impact on self-esteem. They reduce opportunities for those affected, such as avoiding school trips and sleepovers.  In extreme cases they can cause symptoms of depression.

Where can I go for more help?

Treating bladder and bowel problems may be straightforward, but for some people treatment takes time and effort for improvement.  However, most can be treated.  So, if you or someone you know is affected do ask for help.  School nurses run drop-in clinics in most secondary schools. Your school reception should be able to tell you when the nurse is going to be in school. You do not need to tell them why you want to see the nurse. 

You can tell your parent or carer and ask them to make you an appointment to see your GP.  If you are over 16 years old, you can register with a GP and make an appointment on your own.

For more information visit www.bbuk.org.uk and www.stopbedwetting.org

Bladder & Bowel UK also provide a confidential helpline service at email: bbuk@disabledliving.co.uk or on telephone 0161 607 8219

By Davina Richardson, RGN/RSCN Specialist Children’s Nurse, Bladder & Bowel UK

MN/2040/2019/UK
Date of preparation: November 2019