For older children with CP, bladder and bowel continence can be common problems. CP can cause issues with muscle tone and spasticity, which affect the muscles that control the bladder and bowel. It can take longer for a child with CP to learn this control.

Incontinence can cause distress for children with CP, particularly in social situations and at school, and impact their quality of life. It’s important to talk to your healthcare team about how to access the most effective treatment and support your older child through their continence challenges.

Urinary incontinence can be due to an underdeveloped bladder, genitals, urinary tract or urethra. Urinary incontinence may be an issue that comes and goes, or it can be continuous.

Your child may be having issues with urinary continence due to:

• an over-active bladder, which can cause your child to feel a sudden need to wee often due to the bladder not storing urine properly
• overflow incontinence, when leaking occurs due to the bladder not emptying fully
• functional incontinence, when your child has issues that make it difficult for them to use the toilet, such as problems with mobility or being able to remove their clothes
• pressure on the bladder from coughing, sneezing, laughing or exercising
• going through a stressful time, such as moving from primary school to senior school.

When the muscles in the bowel can’t contract due to less mobility or poor muscle tone, the bowel can’t work properly and constipation can occur. It’s important that older children with CP are aware of this and keep track of their bowel movements, so that any issues can be picked up early.

Constipation can cause:

• pain
• poor appetite
• food intolerance
• vomiting
• urinary tract infections
• problems with absorption of important medication.

A urologist or continence nurse can provide your child with a comprehensive assessment and create a program to help them manage any issues. Treatment options may include special exercises, maintaining a regular toileting schedule, medication, surgery, learning proper toilet posture and biofeedback training (to help you control bodily functions).