How bladder and bowel issues are affecting children at school
Continence conditions are the most common complaint in children according to headteacher.com, with a third of all children in the UK struggling with constipation in particular. This allows us some insight into the potential for toilet issues in schools, and explains why there has been so much discussion around the topic.
Did you know that toilets in schools are being controlled in some cases during lessons? This may be to aid learning outcomes and safeguard children and young people during school hours, but it may also be causing undue anxiety in some children. We all trust educators to do what’s best for our younger generations, and much time and energy goes into ensuring proper regulation is in place. The UK has the second best education system in the world according to recent studies. A ‘good education’ is more than just academic aptitude, however, with more emphasis now being placed on wellbeing and mental health in schools, and more funding being provided to support children post-covid.
What’s the problem with toilets in schools?
This is a complex topic which has caused much discussion, as schools are still largely responsible for deciding how they manage toilet access by pupils. The Department for Education doesn’t offer specific guidance on toilet access and schools are left to create their own policies, which could result in lack of continuity of provision across the UK.
Schools have a responsibility to put safeguarding measures in place of course. They also need to ensure equity in education by remove barriers for those with disabilities or additional needs, however, a child or young person can still be refused access to a toilet during a lesson which that can affect their physical and mental health.
On one hand, the teachers have to make every moment in lessons count, because keeping children’s attention in the classroom is vital to help children achieve their potential. Bathroom breaks mid-lesson can cause disruption. Conversely, there’s no way a child can focus on the topic if they need the toilet. The anxiety, physical discomfort and peer influence can be overwhelming.
We spoke to Robyn, aged 19 who told us:
“Holding in your bodily functions is unhealthy which is what students are having to do. Some schools unlock toilets during break and lunch but it is such a small window that there isn’t enough time or cubicles for everyone to use them. Many schools give children with medical issues a pass to go during lessons. However, in my personal experience it is humiliating to be singled out using the pass. There are times when a teacher would say yes to me and no to others which resulted in my peers saying things like “how come she gets to go but I can’t”.
Getting this sensitive topic right during a child’s formative years is most important. So what can schools do to get the balance right? How can we ensure children’s toilet needs are advocated for, whilst ensuring proper safeguarding and emotional welfare?
1 in 9 children in the U.K. are affected by a bowel or bladder condition including constipation, soiling and wetting accidents and bedwetting.
– Eric.org.uk
In order to delve deeper into this topic and understand all perspectives we spoke to ERIC, the children’s bladder and bowel charity is dedicated to supporting children and parents with bladder and bowel conditions. Their work supports all aspects of a child’s bladder and bowel health, including their time at school. In this article they discuss toilet access in schools, stating that banning toilet breaks shows a lack of respect for children.
Juliette Rayner, CEO of ERIC, The Children’s Bowel & Bladder Charity told us:
“Access to toilets is a fundamental human right. All children and young people should have access to facilities that are clean, safe and that they feel comfortable to use – whenever they need to. Banning toilet breaks during lessons or restricting access to the toilets can aggravate or even create continence problems.
Consequences can include:
- Soiling and wetting accidents in the classroom
- Urinary tract infections
- Withholding which can lead to constipation
- Children reducing the amount they either eat or drink in the mistaken belief that this will stop them needing to use the toilet
- De-hydration and lack of concentration which affects their school work
- General anxiety around using the toilet outside of the home
Unfortunately, there’s no law stopping schools from locking toilets during lessons, but that doesn’t mean they should do it! Banning toilet breaks shows a lack of understanding of pupils’ health needs. For a child with urgency problems, this is not a feasible solution.”
Robyn is passionate about raising the conversation to ensure children are suitably understood and their needs are met. Having left school last year she wanted to help tell the story from a student’s perspective in order to influence change in how schools approach toilet access. Having recently left the schooling system in the UK, she told us:
“Scrutiny and restrictions on toilet use in school exacerbated my IBS, bladder incontinence/overactivity, and GAD and I want to spread awareness to prevent other young people from developing problems.”
Here, we delve further into the topic of toilet access in schools with Robyn to understand more.
Toilet access in schools – a student’s views
Can you tell us how old you were when you first experienced issues at school, and how this all started?
I think I was around seven years old. I had my hand up for the majority of the lesson and I don’t know whether the teacher did not see/hear me or was just ignoring me. By the time I was allowed to go I had an accident on the way to the toilets. I had to sit in the back of the classroom for the rest of the day. It was quite embarrassing.
Do you feel the effects of the pandemic were in any way a factor to your condition, and schools’ response to toilet access?
During lockdown when we had online lessons at home, education was much more accessible for me as I could go to the toilet with no worries and also not miss any work. My anxiety and the effects of my bladder and bowel conditions were reduced during lockdown. The school’s response to toilet access did not change.
Does the taboo of ‘poo and wee’ form part of the problem in your experience, and how could schools address this?
I think wider society’s whole attitude towards normal bodily functions is the problem. For example, people will walk into public toilets and vocally state with disgust how it smells which is odd as it is a place where people go to the toilet, it’s going to smell and that’s normal. I don’t think schools would be able to completely normalise bodily functions but they could maybe help to normalise bladder and bowel conditions. Even a brief powerpoint on them in form may be beneficial. The next time someone walks into a public toilet and wants to say something about the smell might think ‘wait, someone could be emptying a stoma bag in here or dealing with another illness that we talked about in school, I probably shouldn’t say anything’. The taboo is just very hard to erase.
Do you feel that genders were treated equally when it comes to toilet needs during lessons?
In my case they were treated equally.
In your experience, why do schools lock the toilets? Can you tell us more about ‘locked toilets’ in schools, and how this affected you and/or your peers?
Luckily when I was at school they did not lock the toilets and the restrictions on them were
verbal. By this I mean being told you’re not allowed to go or being met with responses such as “I don’t know, can you?”, “can you not wait twenty minutes”, “are you really desperate?”, “It was just lunch/break”. There were also school rule posters that included not asking to go to the toilet in lesson. This made me so anxious about asking to go that I would be distracted from my work as I was worrying about whether I would need to go during the lesson. When my anxiety was heightened I would experience flair ups in my ibs or overactive bladder.
From what I have read in articles such as BBC’s newsround article about locked toilets in school’s the main defence of schools is ‘safeguarding’. It is true that by locking the toilets students can not break rules such as vaping but they may be sacrificing the wellbeing of other students’ bladders and bowels in the process.
Did you have a supportive peer group at school, and did this help you?
My friends were greatly supportive of me. For example, when I would be nervous about asking to go or getting up in front of everyone they would reassure me that it is okay that I need to go. I was very lucky to have friends who understood anxiety and health conditions.
Some schools issue toilet passes to ensure children are accounted for, and reduce unnecessary toilet visits – is this a suitable solution do you think?
Toilet passes for those with health conditions is great in theory but there are issues. For example it can be marginalising and turn your peers against you. There are times when others in class were told they are not allowed to go to the toilet but then I was told I could go. This resulted in responses like “How come she’s allowed to go but I can’t?”. This was embarrassing to me and unfair to them. We have to think about students who don’t have a pass who may develop health conditions due to not being allowed to go or have an undiagnosed condition. People who need the toilet should be allowed to go to the toilet without some sort of formal piece of paper.
What do you think schools could do to better support children with bladder or bowel conditions in schools?
They need to provide private and accessible facilities. They need to normalise the fact that young people might need to go to the toilet during lessons and not react to it as an inconvenience. If during an exam a student experiences a flare up, the school should allow them to leave the exam and come back to it when they are well enough to focus. I also think that attendance awards need to stop as they are unsupportive of students who have to miss school due to health conditions.
How do you feel schools support Mental Health in general, and what more do you feel they could do to help young people with bladder or bowel issues?
The truth is that since the majority of schools in the UK have become academies that run like businesses there is a focus on attendance and league tables while mental health is pushed aside. In my experience schools address the mental health crisis with very vague information and services. I think schools could support young people with bladder and bowel issues by letting them know that they are not alone and that they shouldn’t be embarrassed. They could refer them to websites such as the bladder and bowel community where they can join support groups and get resources like the ‘Just Can’t Wait Card’. Another useful resource would be letting students know where to get a radar key. Normalising students going to the toilet during any time of the day would help those with health conditions feel less anxious.
Is there anything further you would like to add?
I would like to add that I recognise that schools are struggling with limited resources and funding which I greatly empathise with. Many staff in the school I went to were supportive and accepting of my health conditions which I greatly appreciated. I can’t completely blame school for my health conditions as there could be other external factors but they definitely fueled the fire with their attitude towards students going to the toilet. However, I worry for current students in schools with much stricter rules such as locking toilets and want to spread awareness of the possible consequences of this.
There needs to be a solution to safeguarding issues that doesn’t involve locking the toilets, decreasing privacy, or limiting when students can go.
We’d like to thank Robyn for sharing her story and explaining how difficult living with a bladder or bowel condition can be, especially during teenage years. With schools becoming more aware of the issues at hand, we hope that suitable solutions can be sought to keep children safe, and their health needs met. If you would like to share your experiences, we’d like to hear from you – contact us here.
Further Information
If you feel that you need support one-to-one for a specific bladder or bowel issue, you can contact the ERIC helpline team. You can do this over the phone or via email – whatever is easiest for you. Details of this can be found here: https://eric.org.uk/helpline/.
You can learn more about bowel care for children, and bladder care for children via our website. You can also read more about why ERIC exists in our article, or visit their website for more information on how to get support.
