Not all health concerns appear suddenly. Some issues develop slowly and stay for weeks or months. They may not always seem urgent, but they can affect how your little one eats and sleeps, and even grows.
Over time, they can also create medical complications if left untreated. As a paediatric surgeon in Johannesburg, Dr Niveshni Maistry manages chronic bowel and bladder conditions, offering support and procedures where needed.
In children, the most common chronic surgical-related conditions include:
- Chronic constipation: When bowel movements are infrequent, hard, or painful, sometimes leading to discomfort and distress.
- Faecal incontinence: When a child cannot control their bowel movements, leading to soiling.
- Urinary incontinence: When a child struggles to control urination, either during the day or night (bed wetting).
Why is managing these conditions important?
Parents sometimes believe their child will “grow out of it.” While this is true for some children, many continue to struggle without support.
Faecal or urinary incontinence may affect physical health as well as your child’s emotional well-being and social interactions. If you address these concerns early, the possible complications will be fewer, which will give your little one the best chance of improvement.
How are these chronic conditions managed?
Management depends on the specific condition, its severity, and the duration of its presence.
Chronic constipation:
- Comprehensive initial assessment and evaluation to identify possible causes such as anatomical problems with the anus/rectum, neurological problems and dietary issues.
- Most cases can be effectively managed with tailored medications and routines specifically designed for each patient.
- In severe cases, surgical procedures may be required.
Faecal incontinence:
- Initial thorough evaluation to determine the cause. Structural problems within the rectum and anus need to be ruled out. Neurological assessments need to be performed.
- Bowel management plans are developed, which may include medication or surgical interventions to ensure that the child remains clean.
- Education and guidance are provided to parents on diet, toilet routines, and supportive strategies.
Urinary incontinence and bed wetting:
- Initial comprehensive evaluation and investigations to determine the underlying cause.
- Bladder training programmes, lifestyle adjustments, and in some cases, surgical procedures to correct abnormalities.
- Support for families in understanding that these challenges are common and manageable.
What signs suggest my child may need help?
You may notice some of the following:
- Painful or difficult bowel movements
- Hard stools or infrequent passing of stools
- Regular soiling or accidents after toilet training age
- Daytime or nighttime bed wetting beyond the expected developmental stage
- Abdominal bloating, discomfort, or repeated urinary tract infections
If these problems persist, it is essential to seek medical advice rather than waiting for them to resolve on their own.
What happens next?
Chronic conditions like constipation, faecal incontinence, or bed wetting can feel overwhelming, but they are more common than many parents realise. With the right management, children can gain relief and confidence.
If your child has ongoing symptoms, booking an appointment with Dr Maistry, a paediatric surgeon in Johannesburg, who can provide the clarity needed to move forward.