Pro-Motion Bowel Training [ProMPT]
The Pro-Motion Bowel Training [ProMPT] Programme was developed to address bowel issues commonly experienced by individuals who have experienced trauma or who have a neuro-disability.
Designed for children and adolescents our ProMPT programme helps with bowel and bowel-related toileting problems.
You do not have to have experienced trauma or have a neuro-disability to use this programme, and for it to be effective. It can be used by any child or adolescent who has problems with their bowel motions.
We know how problems with the bowel and bowel-related toileting can causes distress, low self-esteem, anger, shame, and confusion for the individual. It also affects behaviour.
We also recognize how it interferes with social opportunities like having sleepovers or going on camps, and how it can affect all members of the family.
Pro-Motion Bowel Training (PRoMPT) Programme
PROGRAMME DURATION: 1 Year
PROGRAMME COST: $380.00 [plus GST]
- Initial consultation 1- 1 ½ hrs
- Four further appointments
- Support via email or phone for up to one year.
OPTIONAL EXTRA: One hour Relax Kids Programme sessions to assist with
Anxiety, self-esteem and behavioural issues associate with
RELAX KIDS SESSION COST: $50-00 [plus GST] per one hour session
THIS PROGRAMME WAS DEVELOPED TO ADDRESS BOWEL ISSUES FOR CHILDREN AND ADOLESCENTS WHO HAVE ISSUES WITH CONSTIPATION, SOILING AND TOILET ISSUES. Participants for the programme need to meet the following criteria:
- Two years old or older
- Constipation/soiling/bowel problems for 4 months despite current treatment
- No delay in passage of meconium
- No underlying organic cause eg. coeliacs disease, hypothyroidism, neuromuscular disorder
- Have had a full physical examination by GP (eg. perianal, spinal inspection)
What is Constipation?
This is when there is difficulty or delay in the passage of stool (poo) and may be associated with pain/discomfort. The stools do not necessarily have to be hard. If you child over 1 yr of age has a poo less frequently than every 3 days, they are likely to be constipated. The stool does not need to be hard in consistency. They may not express pain or discomfort like adults. 40% of children who develop constipation often express it through their behaviour.
It is estimated that constipation occurs in up to 10% of children.
Constipation is hardly ever due to an abnormal bowel. Most bowel problems show up in early life and are diagnosed within a few months.
Soiling with Constipation
Soiling is a common problem and affects 2% of school age children. In most cases soiling is dues to constipation.
As constipation get worse and continues for four months or more the bowel becomes stretched, like a balloon blown up several times. (megarectum and megacolon) which reduces the sensation to pass a stool.
When this happens, the child gets little warning or looses rectal sensation and subsequently may start soiling. Often parents interpret this as diarrhea, and this may vary from very runny to formed stool in the underwear. Due to lots of hard stool being retained in the bowel it results in soft watery stools leaking round the hard stool.
This is called Faecal Impaction with overflow soiling
Urinary problems can frequently co-exist with constipation and often improve as the constipation is treated.
The Causes of Constipation
There are many possible reasons for your child’s constipation. In the 10yrs that I have been a Paediatric Bowel Management Nurse the most common reason is CHANGE.
This can be either a positive or negative change.
- Changing diet. Often babies react to a change in diet ie. going from breast to formula ; changing formulas; starting solids
- Change of Environment. The young child starts Kindy or primary school. Moving to a new house. Child moving between houses when parents separate. Going on holiday. Hospital admission.
- Change in health – child/family . Illness especially if it is chronic can have a huge impact on the bowels as they child may not be eating or drinking as they normally would. Some medications given to children can cause constipation. If other members of the family have chronic physical/mental health issues, then again this can result in change for the child.
- Change in Routine. Children like routine and can become stressed with change. The biggest milestone which can contribute to constipation is toilet training. Some children ‘close shop’ once the nappy is removed and will ignore the urge to go for a poo resulting in stool withholding behaviour.
The Effects of Constipation
Constipation with/without soiling can really mess up a person’s life. It is stressful and frustrating for the individual, their parents and caregivers, and other family members.
Many parents have stated that it ‘dominates’ their life and that they are constantly worrying about their constipated child.
Some parent’s comment as she watched are child passing a stool.
"it was like my toddler was in labour and I felt powerless to help. It totally consumed her. Panting, sweating, going red in the face, and bending over my knee. Sometimes she would go and hide. This would occur maybe once or twice a week and the build up to it meant that we often did not go out due to her difficult behaviour”.
“ I cannot work even part time as I get called to the school to sort my child out who has soiled. This can happen 2 or 3 times per week. “
What is the PRoMPT Programme?
The BEACON Aotearoa PRoMPT Programme is coordinated by a trained Paediatric Continence Nurse with over 30yrs in Paediatric Nursing plus 10 yrs specializing in Bowel Problems at Hawkes Bay DHB. She currently sits on the National Executive Board of the Continence Society of New Zealand. She is a Relax Kids Certified Coach which has been valuable in addressing the behavioural issues that often go hand in hand with constipation.
The PRoMPT Programme involves Seven Phases which can take up to a year to complete. Often the length of time the child has had the problem is the length of time for it to resolve. Relapses can occur due to changes that may be out of the child/family’s control ie. illness, family stress.
Download our ProMPT Brochure here
Download our Programme Information Leaflet here
Contact us today to see how we can help.
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