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ICCS S6-9
(P)
THE GASTROCOLIC REFLEX IN HEALTHY CHILDREN DURING TOILET TRAINING:
AN OBSERVATIONAL STUDY
Tinne VAN AGGELPOEL
1
, Stefan DE WACHTER
1
, Julie VERCRUYSSEN
2
, Kelly VAN DER CRUYSSEN
2
and Alexandra
VERMANDEL
1
1) University Hospital Antwerp, Urology, Edegem, BELGIUM - 2) University of Antwerp, Faculty of Medicine and Health
Sciences, Wilrijk, BELGIUM
INTRODUCTION
Peristaltic movements in the colon will lead to filling of the rectum and a defecation urge. This gastro-colic reflex can be
suppressed by contracting the pelvic floor muscles, but retaining stool could lead to stool problems. During toilet
training, children are more responsive to develop functional constipation.
Our aim was to investigate whether and when the gastro colic reflex occurs in healthy toddlers during toilet training.
MATERIAL AND METHODS
Forty children, aged 18 to 27 months, were enrolled during the toilet training process. Prior to the observation, parents
filled in a questionnaire on stool problems, toilet training behaviors and an observational list of meals and bowel
movements.
Children were observed to evaluate the stool frequency and characteristics, such as color and consistency.
RESULTS
We found that 51% of all toddlers make stool within the first 40 minutes after a meal. 25% defecates more than 90
minutes after a meal and 18% 30 to 40 minutes after the meal. Parents report an average frequency of defecation of
1,4 times per day. 59% of the toddlers defecate after having breakfast and 54% after lunch.
Stool consistency type 4 and 6 occurred the most. 35% of the parents reported characteristics of stool problems.
Children not eating regularly high fibre food all showed characteristics of bowel problems.
10% of the children hid while defecating. 13% of the children performed several movements to withhold their stool, like
sitting down and squatting, running around and the potty dance.
CONCLUSIONS
More research on this natural response of the bowel is strongly advised to investigate the clinical relevancy of the
gastro-colic reflex when toilet training children and to provide practical guidelines for parents and health care workers to
prevent constipation problems during toilet training.