Bladder and Bowel Dysfunction (BBD)
Bladder and Bowel Dysfunction (BBD) is a term used to describe problems involving the way the bladder and bowel work together. One common pattern is stool withholding, or functional constipation associated with BBD.
When children regularly hold their bowel movements, it can contribute to constipation and, in some cases, encopresis (faecal soiling). Regularly holding urine can also be associated with voiding dysfunction, where the normal process of storing and emptying the bladder becomes disrupted.
These patterns can sometimes begin with what may seem like simple “bad habits” — waiting, delaying and repeatedly holding on instead of responding to the body’s signals. Over time, repeated holding can interfere with the communication between the brain, nervous system, bladder and bowel, making it harder for a child to recognise and respond appropriately to the need to go.
Why Some Kids “Can’t Go” at School
Some children struggle to use the toilet at school.
Not because they are being difficult. Not because they are lazy. And often, not because there is anything medically wrong.
For some children, it begins with anxiety, embarrassment or simply feeling uncomfortable using a school toilet. But there is another part of the conversation that parents need to be aware of: how children are being managed when they need to go.
In some school environments, children may be told when they can and cannot use the toilet.
“Wait until recess.”
“You should have gone earlier.”
“Not now.”
Although these rules may be intended to maintain classroom routines, repeatedly being declined permission or being told to wait can teach children to ignore their body’s natural signals. A child may begin holding because they are worried about interrupting the class, asking permission or getting into trouble.
Over time, this can develop into much more than simply avoiding the toilet. Some children can develop significant anxiety or even a phobia surrounding toilets, particularly if they have experienced embarrassment, pain, accidents or repeatedly been told they cannot go when they need to. Regularly holding urine or bowel movements can contribute to constipation, discomfort and further anxiety, creating a cycle that can become increasingly difficult for a child to break.
This is an issue parents need to be aware of. Understanding what happens during a child’s school day can be an important part of understanding their toileting difficulties.
Ask questions. Talk to your child about whether they feel comfortable asking to use the toilet. Find out what the school’s policies are and whether your child feels they are allowed to go when they genuinely need to.
Children need to learn to recognise and respond to their body’s signals. A basic bodily function shouldn’t become something they feel they need to earn permission for.
How Hypnotherapy May Help
This is where hypnotherapy can sometimes help.
Children are naturally imaginative and often respond well to storytelling, visualisation and relaxation. Hypnotherapy may help reduce anxiety and fear surrounding toileting, address toilet-related fears or phobias, and help rebuild a child’s sense of safety and confidence.
It isn’t about forcing a child to use the toilet.
It’s about helping them feel safe enough to listen to their body again and gradually change the emotional response attached to the experience.
Because sometimes the problem isn’t really the toilet.
Sometimes it’s a child who has learned that listening to their body might get them into trouble.
