Bullying is usually described as being repeated behaviours that cause physical or emotional pain or distress. It can take many forms, including physical (pushing, shoving, hitting, kicking); it may be verbal, including persistent name-calling or extreme teasing; emotional, such as being repeatedly excluded from activities; it may be racist or sexist; or it may be cyberbullying, which involves using any electronic means to humiliate, harass or intimated others.

Bullying can happen to people of any age and in any situation. Many different people bully, and they do so for a variety of reasons. It may be that the person doing the bullying does not understand the impact of their behaviour. However, it is more likely that the bully is trying to inappropriately cope with stress in their own life or have themselves been bullied. Some bully to improve their popularity, self-esteem or to increase their power or position in a group.

Those who bully will often pick on someone who is seen as different or more vulnerable.  For the bullying to be most effective, the bully will choose a characteristic that their victim is already insecure about.

Bullying and bladder or bowel issues

Children and young people who have a bladder and/or bowel issue and their families are often concerned about bullying, whether or not they have experienced it. Anxiety about bullying is often the reason given for avoiding normal activities, such as sleepovers, parties and residential experiences with schools or organisations such as cubs or guides.

We all need to use the bathroom several times a day. Ensuring independence as soon as possible in this area of development is a focus for most parents of young children.  However, toileting is considered a private activity – children are taught from a young age that this is not a subject for polite discussion. Consequently, there is a natural tendency to embarrassment and stigma for any problems associated with the bladder or bowels. This makes it difficult for families to seek help and advice.

A lack of openness about a key part of the biology of all humans, has resulted in misconceptions. Many people, including some healthcare professionals, are not aware of what is typical in terms of development of bladder and bowel control. There is a common belief that young children will outgrow soiling (pooing in the pants), daytime wetting and bedwetting, even though the evidence suggests that these problems tend to get worse with time for many. There are also some who believe that problems may be an inevitable part of disability or processing differences. This leads to stress and a sense of isolation for many families. Children may be labelled as lazy or naughty. Young people with bladder and bowel issues have reported low self-esteem and feeling that having to keep their condition a secret for fear or real experience of bullying is a heavy burden.

Continence (bladder and/or bowel) issues are among the most common medical conditions affecting those under 18 years old in the UK. While the problems occur more frequently in younger children and those with additional needs, they often have an increasing impact as the child matures and become more socially aware. Furthermore, older children may be at increased risk of bullying and the continence issue may get worse with time, if left untreated.

All children and young people who are experiencing frequency (having to go to the toilet more often than usual), urgency (having to get to the toilet in a hurry), day or night time dampness or wetting, or who have constipation with or without soiling, should receive an assessment of their bladder and bowel health and support with appropriate treatment.  It is usually helpful to let a trusted member of school staff know about the problem. They can arrange discrete open access to the toilet and drinks, as well as somewhere to store spare clothes. For those at secondary school or college, this may take the form of a time out card or medical pass.

Notify the school

Schools should be notified immediately, if there is inappropriate behaviour or bullying directed at the child or young person with the bladder or bowel condition. This includes not only behaviour that occurs at school, but during journeys as well.  All schools should have an anti-bullying policy, which aims to prevent bullying and support learners who have experienced this. The school nurse may also be able to help with both the medical needs and with who to approach about the bullying.

Sometimes bullying, is the result of a lack of understanding. Bladder & Bowel UK have been involved in developing guidance to support nurseries, schools, colleges and others understand childhood bladder and bowel conditions. This is available on the Bladder & Bowel UK website at https://www.bbuk.org.uk/wp-content/uploads/2020/01/Managing-Continence-Problems-in-Schools-2019.pdf

There is also information about the support schools should provide to learners who have a medical condition that requires open access to the toilet, during the Covid-19 pandemic at https://www.bbuk.org.uk/blog/supporting-children-with-bladder-and-bowel-issues-as-they-return-to-school/

Bladder & Bowel UK have a range of information leaflets for children and families affected by bladder and bowel conditions available on their website at https://www.bbuk.org.uk/children-young-people/children-resources/

Bladder & Bowel UK also have a confidential helpline for anyone affected by bladder or bowel conditions. This is available at email bbuk@disabledliving.co.uk or by telephone at 0161 214 4591.