Both encopresis and enuresis are categorised as elimination disorders and are the inability to control defecation or urination in those deemed old enough to exercise control.
All children and young people attending school presenting with bladder and or bowel problems should be assessed by their GP in the first instance. The GP can undertake a history, physical examination and make a differential diagnosis for the child/young person presenting with a bladder and / or bowel problem.
Please refer to the Bladder and Bowel Pathway for Children and Young People available on Urinary Incontinence and Constipation – RefHelp
CAMHS will consider referrals where:
- An initial assessment has already been undertaken by a paediatric service (see below)
- The presentation is psychological in nature, e.g., anxiety, trauma response
- There is a suspected underlying neurodevelopmental condition and the child is over 7 years of age (under age 7 years may be seen in Community Paediatrics where wider neurodevelopmental assessment is appropriate before referral to CAMHS for ADHD assessment, please see Community Paediatrics – RefHelp).
Who can refer:
Specialists only (Paediatricians or the relevant specialist Nursing services) can refer following initial screening to rule out physical causes.
Who to refer (CAMHS)
Initial screening and treatment should be undertaken by a Paediatrician / Paediatric Urologist to rule out physical causes and any underlying medical condition. Where the diagnosis is not clear, referrals may need to be to other specialist services e.g. CAMHS, GI, Neurology etc.
Referrals to CAMHS by specialist services may be considered for any child or young person presenting with enuresis and/or encopresis where:
- The presentation is psychological in nature, e.g., anxiety, trauma response
- There is a suspected underlying neurodevelopmental condition and the child is over 7 years of age (under age 7 years may be seen in Community Paediatrics where wider neurodevelopmental assessment is appropriate before referral to CAMHS for ADHD assessment, please see Community Paediatrics – RefHelp)
Who not to refer:
Children or young people who have not been fully assessed by a paediatric specialist to exclude physical causes.
Please refer to the Urinary Incontinence and Constipation – RefHelp guidance for advice on initial management.
There is more information on the ERIC website which includes a free downloadable toolkit for parents and professionals.
Please see CAMHS Resources and Links
ERIC – the Children’s bowel and bladder charity.
