Duchenne Muscular Dystrophy: Bowel and Bladder Problems


The specific role of Duchenne muscular dystrophy (DMD) in bowel and bladder problems is uncertain although several studies suggest that DMD may cause changes in the smooth muscle of the bowel and/or bladder [MacLeod: 2003]. Whether or not this is the case, boys with DMD have difficulty with bladder and bowel function, particularly after they become non-ambulatory. Initial toilet training may also be problematic.


  • Most boys with DMD have some degree of constipation.
  • A diet with adequate amounts of liquid and fiber is recommended. Boys will sometimes decrease their liquid intake so as not to have to be urinating frequently, leading to increasing constipation.
  • Medication (Miralax) to regulate bowel movements may be helpful. See the Portal's Constipation module for detailed information about doses and other details of management.

Bowel and Bladder Program at School

  • Bladder and bowel problems can complicate, but should not interfere with, school attendance.
  • Boys with DMD should participate in toileting problem solving when possible.
  • Accidents may sometimes occur, and need to be treated with sensitivity. If occurring relatively frequently, a change of clothing should be provided at school.
  • A good bowel and bladder program at school with scheduled access to a bathroom is essential.
  • Personal aides need to be available to help with toileting, preferably male, although many schools have called male teachers or principals in to help with toileting when requested.
  • Bathroom privileges need to be given promptly when asked for by the child, as urgency is often a problem.
  • Information regarding toileting needs should be included in the patient's IEP. See Developing an IEP for Boys with DMD (Parent Project MD).
  • Toileting equipment, such as raised seats and/or lifts might be necessary and should be requested in advance; we recommend a visit to a new school in the spring of the last year in the old school to assess the need for equipment, etc.
  • Use of adult diapers should not be encouraged by the school, although some families will choose them for ease of care. Older boys who are out in the community in their wheelchairs may prefer the use of condom catheters.



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Author: Lynne M. Kerr, MD, PhD - 10/2013
Content Last Updated: 10/2013

Page Bibliography

MacLeod M, Kelly R, Robb SA, Borzyskowski M.
Bladder dysfunction in Duchenne muscular dystrophy.
Arch Dis Child. 2003;88(4):347-9. PubMed abstract / Full Text