Health · England
Help with wee and poo
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Some people leak wee or poo.
You can ask for help.
Tell your GP about leaking wee or poo.
Ask them to check what is causing it.
They may ask a specialist service to help.
A bladder and bowel nurse can help.
They can check your needs and discuss treatment.
They may work with other health professionals.
The nurse may ask you to keep a diary.
Write down drinks, toilet visits and any leaking.
Ask for help if you need it.
Tell them what has changed.
Tell them if you have pain.
Ask someone you trust to help you explain.
Constipation means poo is hard to pass.
Sometimes soft poo leaks around hard poo.
A doctor can help check this.
Ask for your own toilet support plan.
Your plan should protect your privacy.
You should be treated with kindness and respect.
You may need help getting to the toilet.
Equipment or a different toilet seat may help.
Ask for an assessment.
Pads can help some people.
Ask about treatments and other support too.
Do not cut down drinks without health advice.
Staff should explain before examining or helping you.
Ask for support to understand and make choices.
Your privacy and wishes matter.
Tell the nurse if pads do not meet your needs.
Tell them about sore skin or pain.
Ask when your support plan will be reviewed.
Contact your GP if problems continue.
Black or dark red poo needs urgent advice.
Bloody diarrhoea needs urgent advice too.
Call NHS 111 or ask for an urgent GP appointment.
What you can do next
Contact your GP.
Ask about the local bladder and bowel service.
Read NHS continence information Web pageThis link opens another website.
It may use harder words.
More useful links
- Bowel leakage Web page
NHS advice about assessment and treatment.
- Constipation Web page
Signs of constipation and when to get help.
- Supporting a disabled child Web page
Includes toilet support, specialist assessment and equipment.
- Preparing for a bladder assessment Web page
What the GP may ask and how a bladder diary can help.
These links open other websites.
They may use harder words.
Products you can explore
You can look at products on a separate page of this website.
Money earned from these links will help maintain Clearer Support and the My Life My Say app, and provide free advocacy.
Bladder, bowel and continence support
Bladder and bowel nurses, assessment, treatment, toilet support, products and dignity.
Children and adults · England · Services vary locally
Start with an assessment
Incontinence means passing wee or poo without meaning to. It can happen for different reasons, including problems storing or emptying the bladder, bowel problems, medicines or difficulty reaching and using a toilet. Ask the GP about a bladder and bowel assessment and the local continence service. A learning disability should not be treated as a reason to skip assessment or assume that nothing can improve.
What a bladder and bowel nurse does
The service may be called continence, bladder and bowel, or pelvic health. A specialist nurse can assess difficulties, discuss possible causes and agree a plan. Their work can include advice, treatment reviews and teaching supporters. Some services also include specialist physiotherapists. Depending on the assessment, the team may arrange urine tests, bladder scans or referral for further investigations. Not everyone needs the same tests.
Finding the right service
Ask the GP about the local service and referral criteria. Some services accept self-referrals; others require a professional referral. Children may use a separate children’s bladder and bowel team. Community learning disability nurses can help explain needs and coordinate support. Ask about accessible appointments, waiting times and whom to contact meanwhile. A routine referral must not delay urgent assessment when someone is unwell.
Describe the person's experience
Explain when leakage happens, urgency, pain, changes from the person's usual pattern and the support they need. A short record of drinks, toilet visits, wetness and bowel movements may help the clinician. Ask how to record this without embarrassing the person. Clinicians may examine the person or arrange tests, explaining each step accessibly and seeking appropriate consent. Ask whether the service wants a bladder diary, bowel diary or both, and for how long. Record actual observations and identify anything uncertain. Include relevant medicines and the support needed to use the toilet. The team should help make recording manageable; a diary is not a diagnosis.
Look out for constipation
Hard, difficult or less frequent poo can mean constipation. A person may show discomfort through changes in sleep, appetite, mood or activity. A build-up of hard poo can cause watery poo to leak around it: this is overflow, not proof that constipation is absent. Contact the GP promptly if you suspect constipation; do not wait for it to become severe. Do not attempt to remove stuck poo yourself. Children need an age-appropriate assessment and treatment plan.
Support comfort and independence
Ask what the person wants help with: recognising the need to go, communicating it, clothing, getting onto the toilet, wiping or washing. For children, an occupational therapist can advise on toilet seats and adaptations; physiotherapy may help with positioning and movement. Learning new toilet skills can take longer. Agree realistic goals based on assessment, with privacy, choice and dignity throughout personal care. Adults can also need assessment of toilet equipment and mobility. Discuss lighting, signs, clothing, privacy, sensory needs and whether help arrives promptly. The plan should fit the person’s communication and daily life.
Treatment and products
Treatment depends on the cause. The clinician may discuss bowel treatment, bladder training, medicines or other specialist support. Pads, protective bedding and skin care can be useful but should sit within a reviewed plan. Ask about fit, comfort and local supply criteria; provision varies. Do not restrict drinks or change prescribed medicines to manage leakage without advice. Existing swallowing or fluid plans also need to be considered. Ask the nurse to assess skin soreness and whether products meet actual needs. Pads should not replace assessment or appropriate treatment. If supplies are inadequate, request reassessment and written reasons. NICE advises sufficient pads for an adult’s assessed bowel-incontinence needs. Local arrangements should not be treated as proof that an unmet need is acceptable.
Working together and reviewing the plan
The continence team may work with the GP, learning disability nurse, occupational therapist, physiotherapist or dietitian. Ask who coordinates care and reviews progress. Record the person’s goals, agreed support, product arrangements and review date. Explain if discomfort, skin damage or leakage continues. Ask how supporters will learn the agreed techniques. Intimate procedures need appropriate clinical assessment and trained support; do not improvise them.
Privacy, consent and adjustments
Speak directly to the person and explain each step accessibly. Offer time, communication support and a trusted supporter if wanted. Agree how the person can show discomfort or ask to pause. A learning disability does not automatically mean someone cannot consent. Where capacity is in question, the correct decision-specific process is needed. Keep intimate records private and share relevant information appropriately with the care team.
When to seek more help
Arrange a GP appointment for leakage or a persistent change in bowel habits. Seek an urgent GP appointment or NHS 111 advice for black or dark red poo, or bloody diarrhoea. Tell professionals about new symptoms even if continence difficulties are longstanding. Ask who will review the plan, how to report worsening symptoms and what to do if treatment is not helping. Use the linked constipation and urgent-health guides for further warning signs. Do not wait for a continence appointment if urgent help is needed.
Words you could use
“Please assess the cause of these bladder or bowel difficulties and help us make a comfortable, dignified support plan.”
More useful links
- Bowel leakage Web page
NHS advice about assessment and treatment.
- Constipation Web page
Signs of constipation and when to get help.
- Supporting a disabled child Web page
Includes toilet support, specialist assessment and equipment.
- Preparing for a bladder assessment Web page
What the GP may ask and how a bladder diary can help.
These links open other websites.
They may use harder words.
Products you can explore
You can look at products on a separate page of this website.
Money earned from these links will help maintain Clearer Support and the My Life My Say app, and provide free advocacy.
Where the information comes from
Links checked 1 November 2026.
These links open other websites.
They may use harder words.
- NHS: urinary incontinence Web page
Assessment, treatment and support for bladder leakage.
- NHS: bowel incontinence Web page
Bowel leakage and symptoms needing urgent advice.
- NHS: constipation Web page
Constipation, impaction and overflow leakage.
- NHS: caring for a disabled child Web page
Individual toilet learning, assessment and adaptations.
- NICE: faecal incontinence guidance Web page
NICE guidance hosted by NCBI: equal assessment pathways and additional support for learning disability.
- NHS England: constipation campaign guidance Web page
People with learning disabilities who may have constipation should receive prompt support from their GP practice.
- Kent Community Health NHS: continence service Web page
Example of specialist nurse and physiotherapy roles, assessments, investigations and referral routes. Local access and provision apply to Kent.
- NHS: diagnosing urinary incontinence Web page
Symptoms, medicine history, bladder diaries and investigations.
- NICE: faecal incontinence recommendations Web page
Individual assessment, toilet access, skin care, sufficient products and equal care pathways. Adult guidance.
- NHS: help with personal care Web page
Mobility, skin problems and referrals to continence and other professionals.
- NHS: Mental Capacity Act Web pageFuller information
Consent support and decision-specific capacity from age 16.