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Bedwetting Misunderstood but Often Treatable

Parents Often in the Dark About Why Kids Wet the Bed and What They Can Do

Hidden Cause of Bedwetting continued...

"It's a subtle thing and people often dismiss it," Hodges tells WebMD. "But it is not just simple constipation; it can also mean rectal tone and is often missed."

Hodges says many parents mistakenly think constipation in children only means rare or hard bowel movements. Instead, he says the most common symptom is abnormally large bowel movements.

Excess stool in the large intestine can put pressure on the bladder and reduce its ability to hold urine, leading to bedwetting. An ultrasound or X-ray can reveal stool in the rectum, and treatment with laxatives or enema usually resolves the issue.

Hodges recently published a study in Urology that showed four out of five children who wet the bed showed signs of constipation in X-rays, even though only 1 in 10 had constipation symptoms. Once the children were treated with laxatives or enemas, 83% no longer wet the bed within three months of treatment.

Treatments to Stop Bedwetting

Once the cause of bedwetting is identified, Kiddoo says the most critical aspect of treatment is reassurance for both the parent and the child.

"If it is just nighttime bedwetting, it is not medically serious," says Kiddoo. "But parents should also be aware of the impact on kids. We don't want to minimize how it's impacting their quality of life."

Treatments for bedwetting include:

  • Bed alarms. The report shows alarms that sound or vibrate at the first sign of moisture are the only treatment that has been shown to have a lasting effect on bedwetting. A recent study showed 66% of children who used a bed alarm were dry for 14 consecutive nights compared with 4% of children who had no treatment. These effects persisted after the alarm was stopped.
  • Lifestyle modification. Drinking less at bedtime, reducing caffeine, and having incentives such as rewards may help.
  • Medication. The drug desmopressin may help children who wet the bed due to overproduction of urine, but the effects stop when the medication is discontinued. Tricyclic antidepressants, an older form of antidepressants, may also be helpful to some children, especially teenagers who are also experiencing depression. But these drugs can also have unwanted side effects.
  • Alternative therapies. Hypnotherapy, acupuncture, chiropractic treatment, and psychotherapy have been tried for bedwetting, but researchers say there is little evidence to support these treatments.
  • Taking no action. Bedwetting is a common condition and there is a natural cure rate as a child matures: 15% of children per year will stop bedwetting with no treatment.
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