Giggle Incontinence

[phunphysio]

I have today recieved a referral for an intelligent 10 y.o.boy diagnosed with giggle incontinence. He looses his whole bladder when he laughs, not just a few drops. I am yet to assess this boy but would appreciate any thoughts or experience in this area. I have treated kids with weak pelvic floor before but giggle incontinence is a new area for me. I am doing some literature searches now and all I have found is ritilin? Looking forward to your thoughts

Similar Threads:

• Stress Incontinence
• Male incontinence
• female incontinence
• Womans Incontinence
• urinary incontinence

[junior_physiotherapist]

Hallo,

Well, lets determine the cause of incontenence upper or lower motor neurones,social ,psychological,......

Try Kegel exercises,
strenghteninging core muscles of trunk,
biofeedback training,

[giggler88]

phunphysio-

I hope your treatment is going well with the boy.
In the meantime.
I have giggle incontinence, and have had it for now nine years.
Yes. Nine years.
God, nine years.
This "condition" has completely wrecked my life. I have only recently begun seeing a counselor for it, and she told me that I have a lot of anxiety issues. A lot of problems with letting go, in all aspects of my life. I don't trust anyone, I don't like drinking alcohol past a "tipsy" stage, I have problems with sex... the works. While to some this condition may seem laughable, it almost makes me wish I had a life-threatening disease, because people just don't understand. I wish it was something that I could control. But I can't. I am now at the point where I lose control about once a month, but then again, I avoid funny situations like the plague.
Also recently I have been researching giggle incontinence because I want to learn more about it- maybe find someone else in my situation that I can talk to. So far I have only found a few myths to debunk.
Evidently some doctors say to go to the bathroom more frequently; to drink less water before a funny event. I'm sorry, but this just does not work. Granted, it helps, of course, but I've had times where I would go to the bathroom (they ran tests and found I can completely empty my bladder) and then five minutes later I would have an "episode". In which all of a sudden my already empty bladder would empty itself again.
I tried Kegel exercises early on and it never helped. It's not that we cannot control normally, it's that a part in our brains just shuts down. No matter how strong the actual muscle may be, there is no control.
My best advice to anyone with giggle incontinence is to get on Ritalin and trying it out. I never did, I went on some other drug whose name I do not remember any longer, since I stopped using it about five years ago. Needless to say, it did not work. I am very wary of using Ritalin myself, but I would not bother now- the episodes are too few and far between. But for any child or teenager who pees themselves when laughing-- try it out. And as soon as possible, because of the psychological effects that will occur. Parents, if you're reading this, don't let your kids live with this condition. I wish my parents had made me gone on Ritalin. But it's too late now. Also, if you happen to see your child/teenager washing their pants or underwear, or if you happen to smell urine when you shouldn't, ask them. Because they are going to be far too humiliated to say anything until the last minute. I would know, it happened to me.
And now before I start crying, I'm going to end this post...

[looolaaa]

hello

first of all am so sorry giggler for the condition u have, n i`m trying to understand how embarrassing is this.. but as we all know that the brain is plastic and can reorganize itself, so i think kegel ex`s, stability ex`s esp. for transverse abdominis. he`s a10 y/o so i think it`s a case with a good prognosis esp. that he`s not complaining from the urine incontinence all the time just when he laughs.

but i have a Q : how to assess pt. with urine incontinence?

[phunphysio]

This was a long time ago now. We assessed this boy in terms of pelvic floor strength, general TA strength with the boy doing the palpating and talking him through what he was feeling. Luckily he was quite mature here. We went onto Kegel type exercises with modifications for a 10 year old boy with somewhat poor body awareness. We talked about his triggers, type of laughing and practiced being very stupid during therapy to work harder on the actual triggers. We were successful with 7 treatments and I am happy to report the boy continues to do very well.

[giggler12]

Hi im 12 years old male and iv had this all my life and i hate it i cant go out because if i do it will always happen but good luck with the boy

[mom123rn]

I'm new to this blogging, but I must add to this in my desperation for help with giggle incontinence. My 18 yr old has had it and it is so bad at this point I don't think she can go off to college. I've taken her to Riley's Childrens Hospital. Tried Ritalin, didn't help. Ditropan didn't help either. Maybe the dosing of the Ritalin was not enough...Ugh...I had this as a child, but not this bad. It is a daily problem for her. Maybe even 4X's if friends are over. She has hid this problem until recently. She has been popular, very smart, and now there are a few mean girls who have found out and make fun of her. I am going to try Sudafed...I've been reading and the Dr had mentioned this to me once. I will post later of our progress. I cried reading your post giggler 88. This is a horrible problem.

[killjoy1991]

Hi im new to this.
I have suffered this since i can remember and as a child i was in and out of hospital numerous times and they found nothing wrong and put it down to me just being lazy.Now i am 20 years old and have 2 kids so need to see a physiotherapist and i confided in her which i have never done before about my problem and she told me i may have giggle incontinence.She has checked my pelvic muscles and they are very strong so that wasnt the problem.Kegel excercises dont help,neither does drinking less.Im pretty much on the same boat as the person below and giggler88.I dont know what to do anymore,i have no life and in fear everyday incase i have an accident.Im getting transfered to another hospital so we will see what happens.Im just thankfull that i am not alone in this and that im not the only person that has this which i thought i was up until now.I just need someone to talk to that knows what i am going through.x

[Elibert]

I have today recieved a referral for an intelligent 10 y.o.boy diagnosed with giggle incontinence. He looses his whole bladder when he laughs, not just a few drops. I am yet to assess this boy but would appreciate any thoughts or experience in this area. I have treated kids with weak pelvic floor before but giggle incontinence is a new area for me. I am doing some literature searches now and all I have found is ritilin? Looking forward to your thoughts

In the UK there seems to be even less understood about Giggle Incontinence (bad name - should be belly laugh incontinence...). My 12 year old daughter has struggled through the last few years voiding at least once a day at school, (unless her friends are away - she doesn't laugh hard then). Pads can't cope with total voiding. Her muscles are fine (she can stop when she has an urge - stop/start on the loo etc.) but she experiences complete and uncontrollable voiding when she laughs hard. According to one consultant we saw, she should avoid laughter... Yeah right - he'd be offering electric shock therapy next.

Through research and pestering consultants I found a specialist in the UK who had successfully treated children with Ritilin. We saw her 5 days ago, she concurred with the conclusion that it was Giggle Incontinence which is a cataplexy and so to do with brain function rather than a stress incontinence which has physical roots. We picked up a prescription for Ritilin. Thank God. I had not dared hope that this would solve everything, but it really has.

If Giggle Incontinence was a physical problem that could be solved with kegel exercises Ritilin would have no effect. Yes, trying to make sure a child voids frequently so that the bladder is always as empty as possible can mitigate the problem, but is no solution. Ritilin does not 'cure' her - if she stops the Ritilin, the problem would be back - but heavens does it improve her quality of life. So far, no side effects - other than an extremely happy daughter and an absence of odour...

Any doctors reading this please be aware that there is significant evidence that true Giggle Incontinence is a cataplexy and please treat it as such so that more children like mine can lead normal lives and not suffer the emotional damage that several contributors to this column have experienced. Education, education, education.

[nongigglersunite]

I also have, and still do suffer from this.....and as the rest of you know-its hell to put it nicely. (excuse my language)
I have had it my entire life, and now as a 14 yr old girl, I still have not just "grown out of it" as I was always told i would. Nonetheless, I didn't get my hopes up then either. My mom has it too. And now my younger brother. So yes, I would confirm the theory it is hereditary. But what makes me mad is that there is still no cure, no treatment that works for everybody. Why? The so-called-experts on the subject don't have any idea what is truly going on, they simply make assumptions, give prescriptions, and send you on your merry way only to find 6 years later that it was all only wishful thinking. I have tried every ADD pill out there, I have tried ditropan, which actually did help to a point, and I have tried various combinations of these two forms of "treatment." Kegal exercises are no help, as it is not the issue. I believe that unless the specialist or "expert" on the topic has it themselves, they are not qualified to take patients with the condition. Because only we can understand what we all go through. I'm sorry, but I will never sit in a cold, sickly purple, doctors office and be told to my face:

"There is nothing I can do for you. Just deal with it. There are people out there dying of diseases, you really don't have it that bad"

No offense to those who know someone with a fatal disease or have one themselves. But I see no difference. Sure I may not die from it directly. But becuase of it at 12 years old I considered suicide. Aside from the fact that I practically have no life anyway. We can't have fun for fear we may laugh. We cannot enjoy the time we have on this earth becuase of the personal consequences for us. We have no hope for treatment. For a cure. And yet there are people spending great sums of money on things that will mean nothing once they are gone. Plastic surgery for example.....

Those of us with the condition know how hard it is.....to have friends, to be social at all,....and especially to have a boyfriend, girlfriend, or spouse. I "live" each day in fear that its only a matter of time until they all know my secret....only a matter of time until it happens while I'm with a guy, just hanging out, and never be able to face him again. Its torture seeing other people laugh and have fun, and knowing that could never be me. Will never be my younger brother. Was never my mom.

However, I will remind us that although its hell, we have a special quality not many people have. We will never judge another person for their petty faults. We are not as shallow as the majority of people in todays society. We learn to be accepting and show humility. We tend to be more humble and care less about material things because we see how valuable true joy really is. Ironically, that is my middle name.

<3 to all my fellow (non)gigglers out there. together we will win this battle.....

[nongigglersunite]

im sorry but i love how you seem to completely disregard the fact that we've all "been there, done that" and that your suggestions are of no help as they are no different from anything else we've already been told-which didn't work anyway. So I would ask that everyone would please stop giving the same suggestions to people with this condition. It is cruel in a way to make us think we may have a chance at life, only to find that there is no cure or treatment.

thanks but no thanks

[estherderu]

dear everyone,

I have been following this discussion since it started. Have never reacted because of my lack of knowledge on the subject.
Thank you all for sharing your thoughts and deepest feelings. It must be something terrible to have.
Nearly all the people reacting are from the general public, not many are colleague health professionals.

I have often thought it a shame that none of us reacted. The reason probably being that it is not a disorder we physiotherapists see often.
Because this problem is one that is affecting you so much ...... I will try.
I have never come across a child with this disorder... so pardon my ignorance.

Thought I would do my share of looking for information.... most probably things you already know but... I will give it a try...
And I do think it is important that we professionals know more about this condition as well.

The official description is enuresis risoria.
In the pediatric population, giggle incontinence usually refers to urine leakage associated with laughter. A detailed history often reveals some degree or history of urgency and dampness at other times as well. In these cases, there is usually some underlying bladder instability and treatment with an anticholinergic may be of benefit (Chandra, Saharia, Shi, & Hill, 2002). An entity rare in children, giggle micturition, or enuresis risoria, refers to the complete loss of urine associated with laughter, rather than just leakage. History is usually negative for urgency or dampness at any other time. Anticholinergics are generally ineffective, but some benefit has been derived from methylphenidate (Ritalin®), based on the suggestion that the condition is central in nature and related to cataplexy (Sher & Reinberg, 1996).

A little more on the subject below:
I could only read the abstracts

Treatment of enuresis risoria in children by self-... [Br J Urol. 1995] - PubMed - NCBI

Elsevier

http://www.ncbi.nlm.nih.gov/pubmed/8683753


This is the only recent and free viewable document I found:
http://www.ncbi.nlm.nih.gov/pmc/arti...00027-0123.pdf

Now that I am looking into this I am pretty shocked to find that most of the literature is very OLD and there is not much out there at all!

I will ask my colleagues in Holland that are specialized in treating children with bladder & colon disorders (working in a specialized team) what they know about
this subject.
Please allow a little time...

I promise to get back to you as soon as I know more.

kind regards

Esther

[Kehvet1]

Hello everyone!
I am quite excited to join up as I have had giggle incontinence for as long as I can really remember. I have always avoided speaking about my problem with anyone where possible and I have never been able 2 talk 2 any other sufferers!
I would like 2 say to nongigglers unite that it really is possible 2 have good relationships despite ur condition. I might have been lucky but I am 26 and have been dating the same man for 7years. At first I was so embarrassed and tried my best 2 hide it but I'm sure you will all know it's very difficult! Anyway I spent so long worrying about it but when he found out 2 my surprise he wasn't disgusted (like I expected) he was impressed with how I was dealing with such a big problem and still carrying on my life.
I think the hardest thing about giggle incontinence is the affect it has on ur social life, the one doctor I've ever seen about it told me 2 avoid "high risk" situations and I try 2 do this but it's not very practical is it? Does anyone know whether Ritalin is a viable treatment for young adults or only children? To everyone - keep ur heads up, xx

[Searcher]

I'm a 50 year old woman, college educated and faced this problem as a child. The problem disappeared when i was around 28 and then reappeared when I hit my mid-40s. It's to the point that I avoided groups without realizing this was the reason why.

I also have incontinence (some of the time) when I sneeze or cough. Those are minor, but when I laugh hard, I lose all control. Like Giggler, I can go to the bathroom a few minutes before, and still have this issue.
I'd love to be able to enjoy being with people again in a fun setting, but don't want to have to wear adult diapers to do so. By the way, I do not have medical insurance, our free medical clinic cannot assist, and we don't have money for medical appointments. Yes, I've tried kegel exercises, which don't help.

Any suggestions? Is there a potential that there is something that can be done medically?

[Giggle23]

Hi, appreciate this is an old thread but wondering if there is any further understanding of what can cause giggle incontinence and more importantly successful treatments. My daughter is now 12 and still living with this. It has never been the focal point of her life, but now she's at high school and getting more self aware, she is increasingly becoming upset. She has been doing pelvic floor exercises and on oxybutynin. I'm very worried that she will start to retreat socially and it overtakes her life. It's so hard to see her so upset. Thank you

[beckyjewelry1009]

Trying to see if anyone has had any luck with giggling incontinence? My daughter is 10 and has it. She is on Methtylphendate and Oxybutynin.

[beckyjewelry1009]

Did the Sudafed ever help for your daughter?

- - - Updated - - -

Did the Sudafed ever help for your daughter?

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Did the Sudafed ever help for your daughter?

[nowhereandeverywhere]

I know you wrote to here a long time ago, but I hope one day you are able to see this message, and everyone else on this thread. I am so grateful for what you said, and everyone else here. I have spent my whole life with this issue and experienced everything you are saying, it has also completely ruined my life and no one understands at all. I am now in my late 20s, and I am scared to laugh and enjoy social situations, even though I am an extremely social person. I now feel socially isolated. I have done it to myself both consciously and subconsciously on purpose. I have become very 'serious' out of fear that I might uncontrollably laugh. But no one understands this at all.

I have, however, somewhat found a psychological solution after obsessively analysing this within myself throughout my life. Although I have yet to properly test this in varied social situations, I can still speculate as to why it happens, how to potentially stop it and I have some examples. It has been 6 years since my last public humiliation from this. Since then, I have socialised on occasion, not a lot, but I have. I am going to explain a couple situations in more detail and my analysis of it in a moment.

Throughout my life I would laugh uncontrollably at hilarious things and find things extremely funny to the point where sometimes I wouldn't be able to stop laughing. It was this psychological 'clinging' onto the laughter or the comedic image that I felt I could have some control over. My mind would keep thinking about the funny thing in a self indulgent kind of way. It was always at that point that I would lose complete control. I can't speak for everyone else's experience, but I would be really interested to know what everyone here thinks of this. Next I will give some examples & a further analysis.

Example 1. I was with my boyfriend (who isn't a very funny person, but can be at times & we can be light hearted and vaguely laugh). I got him high on cannabis for the first time and we both hit the giggles. I had never hit them that hard before on cannabis because I have a natural immunity to anything thats funny now. But this was a very unexpected situation. I started to laugh but I was sitting down so it was ok, I was able to put pressure on that area to stop anything from leaking. But then, he needed me to stand up and help him because he couldnt feel his legs (which was also hilarious). I stood up and as soon as I started laughing I had to cross my legs to prevent anything from coming out. It was extremely funny, so I then had to kneel on the ground to stop it, but psychologically I told myself I had to take control and stop laughing. If I had continued standing up, I probably would have leaked everything, but sitting down saved me (as it has many times before). Luckily, my boyfriend loves me and isnt judgemental so he didnt question me sitting down to stop the pee from coming out, whereas in other social situations people would question it and would find that weird. I found that taking a deep breath in & ignoring the funniness of the situation really saved me from leaking everything. The sad part about this is, I cant enjoy funny things as much or for as long, but this might just be a sacrifice we have to make.

Further analysis: I found that this was a lot easier since I am completely comfotrable with my boyfriend. Upon further reflection, there was no social pressure to conform to the hilarity of the situation. I didn't have to feel bad about becoming serious all of a sudden and worry what the other person would think of that. I am a people pleaser and tend to value conformity over taking control of the situation to my own benefit. So this is something I have to be stronger about and learn to do. To only focus on what is going to benefit me in those kinds of situations and be strong enough to take psychological control over it, even if the other person wants to continue to laugh and find it funny. You can also pretend to laugh (which i did a little towards the end just to be more inclusive and warm about it).

Example 2. I was with my mum and we started unexpectedly laughing about something, and a similar thing happened to the previous situation. I felt comfortable enough around my mum to cross my legs and take more control of it. So I think I just need to practice doing this more. Unexpectedly funny things are the worst thing for this. If I'm watching a comedian on the other hand, I can choose what and when I find funny. So my thoughts are, something can be unexpectedly funny, but the moment it is, to train my brain to take control of it in that moment and to not allow myself to indulge in the comedy of it UNLESS I am sitting down. Sitting down seems to be the only way I can laugh, but even at that, I have to be careful for how long I laugh for and always take control of it.

I have read in some comments here that confirms this is a psychological issue. And that say Ritalin works. I wish I knew about this cure throughout my childhood. It would have completely changed my life for the better and I would have been able to develop close friendships with people. But sadly, I had no help. It ruined my life completely. Now that I know about ritalin, I am going to use this for when I'm next in a social situation that might induce a lot of laughter. Even just knowing about that makes me feel a lot better about putting myself in those kinds of social situations without having to worry about being so serious and uptight around people. So thank you all for that. But, I still want to work out a way to do it without that. If it is psychological, there must be a way to train certain parts of the brain naturally (an area that big pharma don't seem to spend any effort or time on at all). I don't want to be confined to a life of taking prescription medication. I try to be as natural and healthy as possible. But I will keep trying my own experiments and keep everyone updated on this forum. I hope you are all still out there listening.

[nowhereandeverywhere]

Are those treatments working for her. I am a woman in my late 20's and I'd really like to get to know the psychological factors that may be involved in the cause of giggle incontinence.

- - - Updated - - -

I know you wrote to here a long time ago, but I hope one day you are able to see this message, and everyone else on this thread. I am so grateful for what you said, and everyone else here. I have spent my whole life with this issue and experienced everything you are saying, it has also completely ruined my life and no one understands at all. I am now in my late 20s, and I am scared to laugh and enjoy social situations, even though I am an extremely social person. I now feel socially isolated. I have done it to myself both consciously and subconsciously on purpose. I have become very 'serious' out of fear that I might uncontrollably laugh. But no one understands this at all.

I have, however, somewhat found a psychological solution after obsessively analysing this within myself throughout my life. Although I have yet to properly test this in varied social situations, I can still speculate as to why it happens, how to potentially stop it and I have some examples. It has been 6 years since my last public humiliation from this. Since then, I have socialised on occasion, not a lot, but I have. I am going to explain a couple situations in more detail and my analysis of it in a moment.

Throughout my life I would laugh uncontrollably at hilarious things and find things extremely funny to the point where sometimes I wouldn't be able to stop laughing. It was this psychological 'clinging' onto the laughter or the comedic image that I felt I could have some control over. My mind would keep thinking about the funny thing in a self indulgent kind of way. It was always at that point that I would lose complete control. I can't speak for everyone else's experience, but I would be really interested to know what everyone here thinks of this. Next I will give some examples & a further analysis.

Example 1. I was with my boyfriend (who isn't a very funny person, but can be at times & we can be light hearted and vaguely laugh). I got him high on cannabis for the first time and we both hit the giggles. I had never hit them that hard before on cannabis because I have a natural immunity to anything thats funny now. But this was a very unexpected situation. I started to laugh but I was sitting down so it was ok, I was able to put pressure on that area to stop anything from leaking. But then, he needed me to stand up and help him because he couldnt feel his legs (which was also hilarious). I stood up and as soon as I started laughing I had to cross my legs to prevent anything from coming out. It was extremely funny, so I then had to kneel on the ground to stop it, but psychologically I told myself I had to take control and stop laughing. If I had continued standing up, I probably would have leaked everything, but sitting down saved me (as it has many times before). Luckily, my boyfriend loves me and isnt judgemental so he didnt question me sitting down to stop the pee from coming out, whereas in other social situations people would question it and would find that weird. I found that taking a deep breath in & ignoring the funniness of the situation really saved me from leaking everything. The sad part about this is, I cant enjoy funny things as much or for as long, but this might just be a sacrifice we have to make.

Further analysis: I found that this was a lot easier since I am completely comfotrable with my boyfriend. Upon further reflection, there was no social pressure to conform to the hilarity of the situation. I didn't have to feel bad about becoming serious all of a sudden and worry what the other person would think of that. I am a people pleaser and tend to value conformity over taking control of the situation to my own benefit. So this is something I have to be stronger about and learn to do. To only focus on what is going to benefit me in those kinds of situations and be strong enough to take psychological control over it, even if the other person wants to continue to laugh and find it funny. You can also pretend to laugh (which i did a little towards the end just to be more inclusive and warm about it).

Example 2. I was with my mum and we started unexpectedly laughing about something, and a similar thing happened to the previous situation. I felt comfortable enough around my mum to cross my legs and take more control of it. So I think I just need to practice doing this more. Unexpectedly funny things are the worst thing for this. If I'm watching a comedian on the other hand, I can choose what and when I find funny. So my thoughts are, something can be unexpectedly funny, but the moment it is, to train my brain to take control of it in that moment and to not allow myself to indulge in the comedy of it UNLESS I am sitting down. Sitting down seems to be the only way I can laugh, but even at that, I have to be careful for how long I laugh for and always take control of it.

I have read in some comments here that confirms this is a psychological issue. And that say Ritalin works. I wish I knew about this cure throughout my childhood. It would have completely changed my life for the better and I would have been able to develop close friendships with people. But sadly, I had no help. It ruined my life completely. Now that I know about ritalin, I am going to use this for when I'm next in a social situation that might induce a lot of laughter. Even just knowing about that makes me feel a lot better about putting myself in those kinds of social situations without having to worry about being so serious and uptight around people. So thank you all for that. But, I still want to work out a way to do it without that. If it is psychological, there must be a way to train certain parts of the brain naturally (an area that big pharma don't seem to spend any effort or time on at all). I don't want to be confined to a life of taking prescription medication. I try to be as natural and healthy as possible. But I will keep trying my own experiments and keep everyone updated on this forum. I hope you are all still out there listening.