Constipation and Bedwetting

Constipation may cause or contribute to bedwetting in some children, according to the results of a new, small study published last month in Urology.

Thirty children with bedwetting, aged 5 to 15, who sought treatment for bedwetting had an abdominal x-ray to evaluate the amount of stool in their rectums. The researchers found that all 30 had excess stool in their rectums, despite reporting normal bowel habits.

After laxative therapy, 25 (83%) of the children were cured of bedwetting within 3 months.  

As a follow-up to this study, I would like to see a larger sample size, a double-blind study (in which children received a laxative or inactive therapy), data 6-12 months later to evaluate relapse, and the timing of the abdominal x-ray to be after the children had a spontaneous bowel movement.

This small study does bring up the importance of looking at bowel and bladder habits when treating bedwetting. Having an abdominal x-ray to evaluate stool in the last 4-5 inches of the rectum would seem important, especially in kids who are not responding to conventional bedwetting treatment or prior to starting medication.

This kind of constipation occurs when children put off having a bowel movement. The stool is backed up and the bowel is never completely emptied.

Here are some tips to manage constipation:

Insure adequate fiber intake.

A guideline for fiber requirements in children is their age plus 6. For example, a 8 year old would require at least 14 grams of fiber a day. My patients' favorite source of fiber is Cracklin' Oatbran Cereal. Read labels when buying food and opt for the higher fiber choice. Fiber bars or drinks can also be used.

Add products such as Miralax.

Ask for your health care provider's guidance, if fiber isn't adequate. Miralax is unflavored and is dissolved in the drink of your choice. It is a gentle way of softening stools and the dosage can be easily adjusted.

Have a regular stooling time, where she sits quietly and has uninterrupted time in the bathroom.

Provide a stool for her to put her feet on and a toilet lid insert if she feels like she will "fall in".

Stop to have the bowel movement when he first gets the message. Holding it in until he gets home can create a vicious cycle.