The middle-of-the-night anxiety associated with youngsters who are still wetting their bed has a possible remedy, and it has to do with bowel habits, not urinary habits.
Researchers at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, recently suggested that parents look to constipation as a possible cause of bedwetting. The reason: if a child is not regularly “going number two,” then it might be impinging on his or her bladder.
Instead of enduring “an unnecessarily long, costly and difficult quest to cure nighttime wetting,” said a Wake Forest Baptist news release, families should seek a doctor’s advice on whether constipation is the culprit.
“Having too much stool in the rectum reduces bladder capacity,” said Dr. Steve J. Hodges, assistant professor of urology at Wake Forest Baptist and lead author of a study examining the urinary and bowel habits of 30 children and adolescents who sought treatment for bedwetting .
All of the subjects had sought treatment for bedwetting, and the majority of them reported having normal bowel habits. Yet all had large amounts of stool in their rectums. Within three months of starting laxative therapy, 25 of the children were cured of bedwetting.
The results of the study were reported online in the journal Urology.
“Parents try all sorts of things to treat bedwetting -- from alarms to restricting liquids,” Hodges said. “In many children, the reason they don’t work is that constipation is the problem.”
The link between bedwetting and excess stool in the rectum was reported many years ago. But the idea of laxative therapy hasn’t gained a foothold because recognizing childhood constipation remains confusing to parents and its diagnosis is not standardized among health care practitioners, Hodges said.
“The kind of constipation associated with bedwetting occurs when children put off going to the bathroom,” Hodges said. “This causes stool to back up and their bowels to never be fully emptied. We believe that treating this condition can cure bedwetting.”
Physicians considering medications or surgery for young patients with bedwetting problems should first obtain an ultrasound or X-ray to determine rectum size and excess stool, Hodges added.
The term bedwetting usually refers to children over the age of six having trouble waking up dry. Of course, when it comes to curing it, opinions differ widely in the medical community.
The site Healthy Children, from the American Academy of Pediatrics, calls bedwetting a common problem and one that parents should not be shy about discussing with their child’s doctor.
A question-and-answer page on the site does name constipation as a possible cause of bedwetting, but considers the usual culprit to be a combination of factors -- such as increased production of urine during the night, a small bladder capacity and poor arousal from sleep -- along with possible constipation.
“Bedwetting Can be Due to Undiagnosed Constipation, Research Shows.” Wake Forest Baptist Medical Center news release, Jan. 27, 2012. Web. 3 Feb. 2012. http://www.wakehealth.edu/News-Releases/2012/Bedwetting_Can_be_Due_to_Undiagnosed_Constipation,_Research_Shows.htm
“Waking Up Dry: Helping Your Child Overcome Bedwetting.” HealthyChildren.org. Web. 3 Feb. 2012.
Reviewed February 6, 2012
by MIchele Blacksberg RN
Edited by Jody Smith