If your child is struggling with a bedwetting problem, you’re probably thinking lots about their bladder – and your aim could be off. The bowels might be the real source of the problem.
Stool backed up in the rectum, the lower five to six inches of the intestine, could be reducing your child’s bladder capacity, says Steve J. Hodges, M.D., author of the new book It’s No Accident: Breakthrough Solutions To Your Child’s Wetting, Constipation, UTIs, and Other Potty Problems (Lyons Press, Feb. 7). In a small study published online Jan. 27 in the journal Urology, Hodges found that among 30 children seeking treatment for bedwetting at Wake Forest Baptist Medical Center, all had large amounts of stool in their rectums, and 83 percent were cured of bedwetting within three months after laxative therapy.
Only three of the children exhibited the signs of constipation parents might notice: hard stools and infrequent bowel movements. For the others, their rectums stretched out to accommodate the extra stool, letting them have normal bowel habits – and even poop several times a day because their was so much buildup. Hodges discovered their constipation only through X-rays.
The Straight Poop
Past research has shown a connection between constipation and bedwetting, but didn’t change clinical practice because doctors focused on classic constipation rather than the hidden buildup of stool.
“The amount of kids with this is much higher than people realize,” says Hodges, who’s a dad himself and treats around 3,000 children per year. It’s brought about when kids put off going to the bathroom and never quite empty their bowels. “Kids are the ones who put off pooping. Adults don’t,” Hodges says. For kids whose toileting habits haven’t yet matured, constipation can be the result.
- Don’t rush toilet training. Hodges says parents are often under pressure to toilet train their kids too early, before age 3. Kids who are uncertain about going to the bathroom hold stool in, resulting in constipation. The high cost of diapers is one factor, but Hodges also wishes camps, preschools and other programs for small children would be “more friendly to Pull-Ups.”
- Insist on a healthy diet. Focus on a whole-food diet for your child, to help keep the stool soft. Hodges says your goal is the same consistency you saw in their diapers as an infant. If you see poop wider than 2 cm (the width of the rectum), your child is starting to get backed up.
- Treat constipation right away. “If you’ve got a kid with obvious signs of constipation, be aggressive with it,” Hodges advises. “If you catch it early, it’s simple.” Parents don’t want to put their kids on laxatives, and he understands that, but warns that constipation left untreated could get so serious it requires surgery. If you notice problems, talk with your pediatrician. One of the most commonly used medications is Miralax, which is over-the-counter but not labeled for children, even though Hodges says it is extremely safe and gentle.
Worth the Effort
If you suspect hidden constipation in your child, Hodges recommends consulting a doctor for an X-ray or ultrasound, rather than just trying laxative therapy on your own. Imaging will give a good idea of how bad the problem is, and whether you are making progress. “You need to know how aggressive you need to be, and when you’re done,” he says.
And though many pediatricians are still unfamiliar with this idea, it is worth discussing. Because another common cause of bedwetting, overactive bladder, is treated with medications that actually cause constipation. And rather than fixing your child’s problem, they could make it worse.
With his book, Hodges is hoping to call attention to this hidden cause of bedwetting and save kids and parents time and trouble – and maybe even some cash. “If people would just toilet train kids later, and pay attention to these issues,” he says, “you would save millions of dollars. My clinic would be empty.”
Find out more at www.ItsNoAccident.net.