Who are we and what do we do?
The service consists of a team of specialist children’s nurses who support individuals with bladder and bowel problems, where primary advice and intervention by GP, health visitor, school nurse or other health professional has not been successful.
We offer a confidential, friendly service, undertake a comprehensive assessment, which may include investigations such as stool samples, urinalysis, ultrasound scans, physical and abdominal examinations.
We provide a programme specific to your condition in order to promote continence. This may include self-help advice, medication, equipment or toileting aids.
Who do we see?
We see children 1-19 years old, who are registered with a Gateshead GP who commonly have concerns such as:
- Constipation
- Soiling
- Stool withholding
- Day time wetting (over 5 years old)
- Nocturnal enuresis (bedwetting)
- Overactive bladder (urine urgency/ frequency)
- Those needing specialist support to achieve their toilet training developmental skill
How to be referred to the Bladder and Bowel Service
If a child and family have followed bladder and bowel care and advice (Level 1) with the support from their GP / other health professional involved in their care for more than 6 months with no improvement then they can be referred to this service.
How to opt into this service after referral
Each referral is triaged to ensure the child’s condition meets Children’s Bladder and Bowel Service criteria. If your child does not meet the service criteria the family and child’s GP will be copied into a letter which is sent to the referrer with information detailing alternate services and support.
If a child meets the service criteria the family are asked to attend a two hour ‘Adult Information session’ prior to being seen. Attendance at this session is essential in order to understand bladder and bowel health and conditions that can occur. If the family choose not to attend the session, then the child will be discharged from the service. A letter will be sent informing the GP / referrer that the family has chosen not to attend.
After attending the information session, the family and child are expected to follow all advice given in the session for a minimum of 8 weeks. If after 8 weeks the child continues to experience on-going bladder and bowel problems with no signs of improvement, then the family are required to contact the service to opt in and request an initial face to face appointment. If no contact is received from the family to request an appointment after 12 weeks, then the child will be discharged from the service. A letter will be sent informing the GP / referrer.
What you can expect at your appointment
A specialist nurse will take a medical history and comprehensive assessment of the child and the family. Information will be taken relating to fluid intake and toileting habits of both the bladder and bowels to give an accurate history. This will include daytime and night-time habits to give an accurate history. The assessment will give the nurse an insight into how best to manage the symptoms and develop a programme of care. It is essential that you bring your child’s assessment charts to every appointment.
The nurse:
- Will undertake physical examinations where appropriate. This may include abdominal examinations and bladder scans. Urine and stool specimens may be required to reach a diagnosis or explore differential diagnosis.
- Will provide health promotion advice and individualised information and update treatment plans and medications in order to achieve healthy bladder and bowel habits.
- May prescribe continence aids to assist the child’s condition or may prescribe disposable containment products for children who have a neuropathic bladder/bowel condition.
- May prescribe disposable containment products for children over 5 years old who have an underlying medical reason for not being able to attain continence. These children must have engaged with an individualised targeted toilet skill development programme for 6 months and not shown any improvements. Targeted toilet skill development programmes and disposable containment prescriptions are required to be reviewed annually as a minimum. This is to assess the child’s development and progress and ensure the appropriateness of disposable containment products before the prescription continues.
Review appointments can be either face to face or telephone appointments. Referral to other Health and Social Services can be supported if appropriate. The child may be referred on to a Paediatrician for further treatment or discharged back to the care of the Health Visitor / School Nurse for ongoing care.
Cancelling your appointment
If need to cancel or rearrange a child’s appointment, please call the service as soon as possible. This service complies with the Gateshead NHS Foundation Trust Policy ‘Safeguarding Children’. Any nonattendance to a child’s appointment will result in a ‘Cause for Concern’ being completed and may result in a referral to social services being made.
Practical advice for good bladder and bowel health
- Aim for a good fluid intake – ideally you should have six to eight drinks, evenly spaced out throughout the day, with the last drink no later than one and a half hours before sleeping at night.
- Avoid drinks which may irritate the bladder and the bowel such as citrus drinks, fizzy drinks, caffeinated drinks (e.g., cola), hot chocolate, caffeinated tea and coffee.
- Eat a well-balanced diet, including two portions of fruit and three portions of vegetables a day for added fibre. Eat these alongside a variety of wholemeal foods and snacks.
- Keep as active as possible, try to get at least 30 minutes of exercise daily.
- Establish a regular toileting routine with regards to both bowel and bladder.
- Ensure you empty your bladder four to seven times a day with a last toilet visit before going to sleep.
- Ensure you open your bowels daily, or on alternate days.
Useful Websites
Service Opening Hours
Monday to Friday 9:00am – 5:00pm
Contacting the Service
Community Bladder and Bowel Service
Bensham Hospital
Saltwell Road
Gateshead
NE8 4YL
Monday – Friday (excluding Bank Holidays)
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