Avoid dehydrating liquids such as alcohol, sodas, and coffee. The recommendations include a thorough disease history should be obtained to define the etiology and specific risk factors for incontinence, characterize the duration and severity of primary symptoms, and capture secondary problems and associated pathologies, validated measures that assess the nature, severity and impact of incontinence on the quality of life should be utilized as part of the medical assessment, a detailed physical examination is an essential component of the evaluation, anorectal physiology testing (manometry, anorectal sensation, volume tolerance, compliance) can be considered to help define the elements of dysfunction and guide management, endoanal ultrasound is useful to confirm sphincter defects in patients with suspected sphincter injury, pudendal nerve terminal motor latency is not routinely recommended, and endoscopic evaluation should be performed in patients who meet general screening guidelines or present with specific symptoms (i.e., diarrhea, bleeding, obstruction) that warrant further evaluation. Devise an action plan in consultation with your childs school, which includes a trusted teachers cooperation at toilet time, and easy access to toilets and a shower. Delayed or slower bowel movements can be caused by a lack of fiber in your diet. 42 Code of Federal Regulations, 410.32 Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests: Conditions, 42 Code of Federal Regulations, 410.33 Independent diagnostic testing facility, 42 Code of Federal Regulations, 410.74 Physician assistants services, 42 Code of Federal Regulations, 410.75 Nurse practitioners services, 42 Code of Federal Regulations, 410.76 Clinical nurse specialists services, Diseases of the colon (e.g., stricture, cancer, anal fissure, proctitis), Metabolic disturbances (e.g., hypercalcemia, hypothyroidism, diabetes mellitus), Neurologic disorders (e.g., parkinsonism, spinal cord lesions), Anal sphincter weakness: traumatic (e.g., childbirth, surgery) or nontraumatic (e.g., scleroderma), Neuropathy (e.g., pudendal nerve damage in childbirth, diabetes mellitus), Disturbances of pelvic floor (e.g., rectal prolapse, descending perineum syndrome), Inflammatory conditions (e.g., radiation proctitis, inflammatory bowel disease), Central nervous system disorders (e.g., stroke, multiple sclerosis, spinal cord lesions), Stress incontinence urine leaks when pressure is exerted on the bladder (e.g., coughing, sneezing, laughing, exercising, lifting something heavy), Urgency incontinence sudden, intense urge to urinate followed by involuntary loss of urine (examples of causes include infection, neurological disorders, and diabetes mellitus), Mixed incontinence - a combination of stress incontinence and urgency incontinence, Overflow incontinence frequent or constant urine leakage due to incomplete bladder emptying, Functional incontinence a physical or mental impairment prevents the patient from making it to the toilet in time, Obstruction (e.g., benign prostatic hyperplasia, cystocele, rectocele, urethral stricture, prostatitis, urethral swelling due to infection), Medications (e.g., antihistamines, antispasmodics, tricyclic antidepressants), Neurologic disorders resulting in a neurogenic bladder (e.g., multiple sclerosis, Parkinsons disease, diabetes mellitus, infections of the brain or spinal cord, stroke, spinal cord injury, major pelvic surgery).