Stool Withholding at School Among Children in the Netherlands

Area of Science:

• Pediatric Health
• Gastroenterology
• Public Health

Background:

• Toilet avoidance and stool withholding in schools can negatively impact children's health and well-being.
• Understanding the prevalence and reasons behind this behavior is crucial for intervention.

Purpose of the Study:

• To determine the prevalence of toilet avoidance and stool withholding among school-aged children.
• To explore gender and geographic differences in withholding behavior.
• To identify reasons for withholding, associated symptoms, and healthcare utilization.

Main Methods:

• A cross-sectional study involving 1000 children aged 8-16 years in the Netherlands.
• An online questionnaire assessed stool withholding, reasons, symptoms, and healthcare use.
• Cochran-Armitage test was used to analyze differences by gender and location.

Main Results:

• Stool withholding was reported by 51.2% of primary and 71.4% of high school students.
• Hygiene (84.3%) and privacy concerns (79.3%) were the main reasons for withholding.
• Abdominal pain affected 50.4% of children, and 12.5% consulted a physician for withholding-related symptoms.

Conclusions:

• Toilet avoidance and stool withholding are prevalent in Dutch primary and high schools.
• Hygiene and privacy are key factors driving this behavior.
• Improving school toilet facilities could mitigate withholding, reduce gastrointestinal issues, and support overall child well-being.