Many people are under the mistaken impression that toilet training is delayed in a child with ARM. While bowel management with enemas is sometimes necessary to allow the child to be clean and not require diapers, the control of the bladder should not be delayed. It is clear that getting the child clean for stool helps get them clean for urine. If urinary incontinence persists after successful bowel management, a urologic evaluation is suggested.
Straining, dribbling, mucous, pain or burning during urination and urinary tract infections (UTIs) are not normal in the child with ARM and should prompt a urologic evaluation.
Some children will wet the bed. This is normal and often will follow a family history of bedwetting. If a child with ARM has persistent bedwetting, follow-up and testing including an evaluation with urology, a baseline kidney and bladder ultrasound, and a detailed voiding and stool diary are suggested. Any anatomical findings on the ultrasound should prompt further investigation. Without testing, no parent should accept that bedwetting in children with ARM is typical.
At Nationwide Children’s, every child diagnosed with a colorectal condition is handled with an individualized treatment plan. For more information or to request an appointment, please contact us.