Many Cases of Bedwetting Tied to Constipation

Bedwetting isn't always due to problems with the bladder. Constipation is often the culprit; and if it isn't diagnosed, children and their parents must endure an unnecessarily long, costly and difficult quest to cure nighttime wetting.

Learn more about Home Potty Training and Pediatric Urology at Brenner Children's Hospital: https://www.brennerchildrens.org/Pedi...

TRANSCRIPT: One of the most frustrating problems for parents is bedwetting or we call it nocturnal enuresis. You have a child that toilet trained early - two or three - just can't keep a dry bed.
It's traumatic, not only for the parents, but also for the child. They can't go to sleepovers, they're afraid to go to camp, it hurts the development of their independence and their self-esteem. So parents are often eager for a cure.
Typically, when I see kids with bedwetting they come into our office and they've been tried out on several medicines, they've been tried on some bladder relaxing medicines from other pediatricians, they've been tried on medicines to limit urine production at night. And the parents have tried every trick in the book, they've tried waking them up two and three times a night, they've tried putting them in underwear so they'll feel the wetness and all that, I can assure, you will fail.
We found through research at Wake Forest Baptist Health that the bowels, believe it or not, you've got to trust me on this one, are a main contributor to bedwetting.
Most of the kids that wet the bed have constipation that's unknown to the child or the parent. What I mean by that is they don't poop hard stools, they don't poop irregularly, they poop every day. But due to the way children go to the bathroom, they have a large burden of stool in the rectum.... So if you clean that out the bedwetting will cease. Constipation can be treated with a combination of laxatives or enemas. But typically, it's best done under the guidance of a doctor.
So a question that parents often have is how can my child get constipated if they're pooping every day or their poops are soft? So what I think the big misunderstanding about this is a semantic one- a definition problem. If you're talking about constipation- you're thinking about people that have hard stools or they stool rarely- when you think about children with bedwetting, the problem is more of a fecal burden.
Imagine an assembly line, that's what the colon is, and it's moving along. The stool moves from the beginning of the colon to the end, which is the rectum, and then you let it out. That's how adults go to the bathroom. Kids don't go to the bathroom that way. When the stool gets to the end, they're playing on their Xbox or they're outside so they hold it in.
And the colon is very complaint- it expands- so the stool builds up and fills the entire pelvis in some cases until they feel the need to go. This doesn't happen overnight, this happens over years, you know, holding slightly every day. But as it builds up, it crowds out the bladder- number one. And also causes a nerve reaction that makes the bladder more hyperactive.
So addressing that stool burden- which is sometimes hidden unless you do an x-ray or ultrasound- is key to treating most voiding problems- especially bedwetting.