Giggle Incontinence

When Sharon* saw her 11-year-old daughter, Alyssa, shoving a pair of jeans into the washing machine, she approached cautiously. This was an all-too-familiar scenario, one she had lived herself throughout her school years.

“I knew I had to level with her, to let her know that as kids both my sister and I had wet our pants when we laughed hard,” Sharon explains. “Apparently, our mother did, too, but she didn’t tell me until I was an adult. I would have given anything to know there were other girls out there like me.”

Dr. Lane Robson, of The Children’s Clinic in Calgary, Alberta, says this problem is more prevalent in girls than boys. Bedwetting is more likely to be a boy’s issue.

“There are a lot of people with giggle incontinence, but it’s important to be clear what giggle incontinence really is,” says Dr. Robson. Giggle incontinence is not like the situation in which you’re tickling your child, and probably due to an overfull bladder at the start of the game, she wets herself and becomes a little damp. “True giggle incontinence is a total dump, a complete emptying of the bladder,” he explains. “It’s not like stress incontinence where a sneeze or a cough can allow some urine to escape. This is a total empty.”

When your child’s afraid to laugh Dr. Robson says that although there is no easy solution, there are ways to handle the problem. “First of all, start off with what I like to call, ‘Good Bladder and Bowel Health’.” In his clinic he works very hard with his patients to teach them proper emptying techniques. “To empty properly, sit centred on the toilet, feet flat on the ground and back straight.” It is also vital to avoid constipation as feces can press on the bladder and can increase the risk of wetting.

Strategies include planning for situations in which a wetting episode is likely to occur and limiting fluids before and during the event. Wearing an incontinence product, dark clothes and trying to remain seated helps lessen the risk of an episode. “Frequent urination before and during an event will help, but none of this will completely avoid an embarrassing episode.” Although no official studies have proven it, giggle incontinence seems to be related to a part of the brain that controls the sphincter muscle. Hearty laughter, or in fact fear, can relax the muscle, allowing a total bladder emptying. Like bedwetting, giggle incontinence seems to lessen with time. However, it can prevent a child from taking part in social events, pursuing careers or situations that might pose a threat of a potentially embarrassing moment for them. And like bedwetting, the emotional side effects might be worse than the actual problem. When asked, wetting their pants in school was one of a child’s greatest fears, almost as frightening as losing a parent.

“The only medication that studies have shown to help is the ADHD drug, methylphenidate. A lot of parents aren’t keen on it due to the side effects, such as mood, sleeping and appetite changes. It’s part of the amphetamine class of drugs,” says Dr. Robson. “If a child is having a wetting episode once a month, medicating them daily is probably not a good treatment. If it’s a daily issue, you may have to make that decision.”

Sharon wishes it were not a trait she passed to her daughter, but she is resolved to help her cope through the years ahead when Alyssa will need her support. “For now we buy products to help, and treat it like it’s no big deal. It will pass.”

* Although wetting is a common situation, the names have been changed to avoid embarrassment.