A Commonly Missed Cause for Bedwetting- Is The Current Treatment Correct?

As nutritional therapists, we talk to our clients about all sorts of things…and we talk about poop a lot! It’s not the most socially acceptable topic to chat about, but it’s important that we discuss what comes out of our bodies because our poop can be a very helpful sign about our health status.

But, wait! This is a post about bedwetting…so why are we talking about…poop? Well, actually bedwetting is very much related to poop- more specifically the lack of regular pooping (or fully eliminating even when “going often”)- you know, constipation!

I recently read this article, which was adapted from It’s No Accident: Breakthrough Solutions to Your Child’s Wetting, Constipation, UTIs, and Other Potty Problems, by Steve Hodges with Suzanne Schlosberg.

It’s a pretty good article and it contains accurate information…constipation CAN cause bedwetting and accidents- it is a commonly missed cause for these problems, especially in children. And, many children with chronic constipation are misdiagnosed because they are going to the bathroom often and don’t seem to have other symptoms of constipation. I suspect, however, that there actually would be more symptoms, just not the classic constipation symptoms that mainstream medicine narrowly defines.

What I strongly disagree with, however, is the standard treatment, which is generally the use of laxatives, fiber or medication. This is NOT the way to go.

Constipation does NOT arise from a laxative deficiency, I assure you, so treatment with those risky medicines are simply a band-aid that does not address the underlying dysfunction and long-term use can cause side effects and actually worsen the problem (and cause new ones). Excessive fiber can also worsen the problem for many, especially young children.

The most important thing,  is that the underlying dysfunction MUST be addressed.

That means the biggest question is WHY is the child constipated?

Sometimes constipation is related to diet or food allergies. Emotions and stress can play a role. However, the true root cause of most chronic constipation  is due to a damaged gut- when an imbalance of healthy gut microbiota leads to a porous (leaky) gut lining.  This needs to be addressed through a gut healing regimen- like the GAPS protocol.

Enemas can be a good, safe, painless and side-effect-free treatment that works quickly and helps stop the bedwetting or accidents. It also helps by unburdening the colon- which is extremely beneficial to the body because the colon can return to its natural shape and the excess feces is not sitting in the body causing a toxic situation. But they are still only part of a comprehensive protocol that involves healing the gut!

Remember: The body speaks to us with symptoms and when those symptoms are covered up and the problem is not fixed, the body must find new ways (MORE symptoms) to communicate with us. To stop this cycle, we simply need to address the root cause and then the body will balance itself and there is not a need for further illness or discomfort.

Has your child experienced bedwetting? Did you find a link to chronic constipation?

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  • My son is still on GAPS diet (still not able to handle honey, raw veggies, raw fruit) and he is still wetting his bed a lot. We keep him in overnight pants because he wets so much and sleeps so heavily. He turns 5 next month. I don’t know what else to do….

    • Hey Heather! Thanks for your comment- I replied on FB, but I do think there is some underlying thing going on- like candida or parasites- or there may be a need for digestive support…many GAPS folks need additional support while going through the stages. If you’d like, let’s set up a free consult to talk further and I’ll see how I might be able to help.

    • If he’s just five, don’t stress. It is biologically normal to not be ready for nighttime dryness yet. My family practitioner tells me that it isn’t unusual for kids to have nighttime dryness issues until they are even 8-10, and this isn’t new. He’s been in the business for many years, and is excellent. If you child DOES have other symptoms that you believe might be related, then by all means, address those, but if he is otherwise doing well, don’t stress about the bedwetting (we call them leaks), his body just isn’t ready yet. Monitor all evening liquids, watch potty habits all day and encourage lots of daytime bathroom use (some kids hold most of it all day, then have a LOT left when they fall asleep), and perhaps do an 11pm potty break every night where you gently rouse him and bring him to the potty (try to do this in the dark, as light will stimulate the child, and move it up if you’ve already missed the potty at 11pm, but no less than one hour after he’s fallen asleep). It will come, but sometimes it just takes longer than we expect.

  • My son is still on GAPS diet (still not able to handle honey, raw veggies, raw fruit) and he is still wetting his bed a lot. We keep him in overnight pants because he wets so much and sleeps so heavily. He turns 5 next month. I don’t know what else to do….

    • Hey Heather! Thanks for your comment- I replied on FB, but I do think there is some underlying thing going on- like candida or parasites- or there may be a need for digestive support…many GAPS folks need additional support while going through the stages. If you’d like, let’s set up a free consult to talk further and I’ll see how I might be able to help.

    • If he’s just five, don’t stress. It is biologically normal to not be ready for nighttime dryness yet. My family practitioner tells me that it isn’t unusual for kids to have nighttime dryness issues until they are even 8-10, and this isn’t new. He’s been in the business for many years, and is excellent. If you child DOES have other symptoms that you believe might be related, then by all means, address those, but if he is otherwise doing well, don’t stress about the bedwetting (we call them leaks), his body just isn’t ready yet. Monitor all evening liquids, watch potty habits all day and encourage lots of daytime bathroom use (some kids hold most of it all day, then have a LOT left when they fall asleep), and perhaps do an 11pm potty break every night where you gently rouse him and bring him to the potty (try to do this in the dark, as light will stimulate the child, and move it up if you’ve already missed the potty at 11pm, but no less than one hour after he’s fallen asleep). It will come, but sometimes it just takes longer than we expect.

  • My daughter has had urinary leaks (not as severe as accidents) since she was potty trained. She’s 10 and finally growing out of that. However, 9 months ago, she started having bm accidents. They’re small though (similar to the urinary ones).
    A doc recently said she might have something that causes constipation and need Mirulax (Polyethylene Glycol). I don’t want her taking that so found an herbal laxitive through Trilight Health. Now I’m wondering if the enema would be better and faster (doc has said it can take 6 months or so). I’m not sure how much energy I have to try to find allergies (been really stressed lately due to 3 moves in 6 months).
    What are your thoughts?

    • Hi DeDe! Thanks for your comment. Off hand, I would suggest trying enemas. They are really easy and painless and can be immensely helpful. If you would like to set up a time for us to talk (a free consult) I can give you some pointers or references to help you if you’ve not done enemas before. We can talk about dietary changes if necessary as well. Just shoot me an email if you’d like to chat. 🙂

    • My daughter went through this after a trip to Disney, where we ate lots of “compromise” foods, which were really pretty low in fiber and high in things we don’t usually eat. We saw the doctor who recommended we get her back on the best possible diet (lots of veggies for fiber, high quality protein, etc.), increase water, milk, and other quality liquids, and encourage longer bathroom visits with reading on the potty at least twice a day to allow any “clenching” to relax. It took about 10 days, but her body did resolve it on its own with this regimen. Good luck!

  • My daughter has had urinary leaks (not as severe as accidents) since she was potty trained. She’s 10 and finally growing out of that. However, 9 months ago, she started having bm accidents. They’re small though (similar to the urinary ones).
    A doc recently said she might have something that causes constipation and need Mirulax (Polyethylene Glycol). I don’t want her taking that so found an herbal laxitive through Trilight Health. Now I’m wondering if the enema would be better and faster (doc has said it can take 6 months or so). I’m not sure how much energy I have to try to find allergies (been really stressed lately due to 3 moves in 6 months).
    What are your thoughts?

    • Hi DeDe! Thanks for your comment. Off hand, I would suggest trying enemas. They are really easy and painless and can be immensely helpful. If you would like to set up a time for us to talk (a free consult) I can give you some pointers or references to help you if you’ve not done enemas before. We can talk about dietary changes if necessary as well. Just shoot me an email if you’d like to chat. 🙂

    • My daughter went through this after a trip to Disney, where we ate lots of “compromise” foods, which were really pretty low in fiber and high in things we don’t usually eat. We saw the doctor who recommended we get her back on the best possible diet (lots of veggies for fiber, high quality protein, etc.), increase water, milk, and other quality liquids, and encourage longer bathroom visits with reading on the potty at least twice a day to allow any “clenching” to relax. It took about 10 days, but her body did resolve it on its own with this regimen. Good luck!

  • I had one that had a lot of problems and we had made a lot of diet changes but with no improvement. I took her to the chiropractor for something else. Our chiropractor asked if she had problems with this and I said yes. She explained to me that every child that she saw with the high tailbone (if I rememer correctly) had bedwetting problems. After the first adjustment she made throught the night for the first time. I had to bring her back for more but the problem is solved now.

  • I had one that had a lot of problems and we had made a lot of diet changes but with no improvement. I took her to the chiropractor for something else. Our chiropractor asked if she had problems with this and I said yes. She explained to me that every child that she saw with the high tailbone (if I rememer correctly) had bedwetting problems. After the first adjustment she made throught the night for the first time. I had to bring her back for more but the problem is solved now.

  • I am the author of the research and book discussed in this article. i am totally in favor of a healthy diet to promote normal bowel habits in kids. we describe the three causes we feel is contributinng to the epidemic of potty problems in our kids, including highly processed western diet, early and poorly followed up toilet training, and unhealthy and restictive bathroom policies of many school (including toilet training requirements for preschools). I just need to make one point. although diets and allergies are a main cause of constipation, the driving factor is stool retention by the children (probably because it hurt in the past or because they simply put off going). in fact in most cases they aren’t truly “constipated”, they all poop regularly, just not on time, so that the stool accumulates and distends the rectum (which is the real problem), leading to incomplete rectal emptying. This is truly best treated with enemas, but keeping the stool soft enough that they are not inhibited to defecate is also important, and you can do all the dietary modification you want to help with that, but miralx does it very easily, very efficaciously, and with no ill effects in over 100 peer revirewed publications. its just a good real world answer. also, i kow many very good and very smart pediatricians that simply missed the boat on this topic. 80% of kids can be cured of bedwetting way before 10 due to the underlying stool burden, and ignoring that rectal distention is not without consequences. Some children becoming so distended that they later need a cecostomy procedure to stay empty. this is a real problem, and it has been ignored for far too long, and i have the stories of stressed out parents and ill (due to neglect of their bowel/bladder issues) children to prove it. we need to truly diagnose (with xrays or other methods) these kids and treat them with any effective means, despite our feelings on the use any of the therapies, for the sake of these sick and suffering children. the rectum is supposed to be 2cm wide, the kids in my clinic have rectums from 6-10 cm wide stuffed full of stool. thats way more unnatural than using laxatives once in awhile, and its not going to be fixed with dietary changes, although once it is fixed the proper diet will prevent recurrence.

    • Very interesting reading Steve, and something that concerns me greatly. I have a 6yo boy with Aspergers who has been ‘withholding’ bowel movements on and off for 3 years now, we think due to his sensory issues (he hates the smell and sensation of bowel movements so avoids doing it at all). We’ve made huge changes to his diet and have seen great, positive improvements in his behaviour and general health, but the withholding continues. I’m certain that he must be suffering from rectal distention and the long term effects of this are very worrying for us as parents. I’ll be speaking with our health practitioner about having this diagnosed at our next appointment. Thank you 🙂

  • I am the author of the research and book discussed in this article. i am totally in favor of a healthy diet to promote normal bowel habits in kids. we describe the three causes we feel is contributinng to the epidemic of potty problems in our kids, including highly processed western diet, early and poorly followed up toilet training, and unhealthy and restictive bathroom policies of many school (including toilet training requirements for preschools). I just need to make one point. although diets and allergies are a main cause of constipation, the driving factor is stool retention by the children (probably because it hurt in the past or because they simply put off going). in fact in most cases they aren’t truly “constipated”, they all poop regularly, just not on time, so that the stool accumulates and distends the rectum (which is the real problem), leading to incomplete rectal emptying. This is truly best treated with enemas, but keeping the stool soft enough that they are not inhibited to defecate is also important, and you can do all the dietary modification you want to help with that, but miralx does it very easily, very efficaciously, and with no ill effects in over 100 peer revirewed publications. its just a good real world answer. also, i kow many very good and very smart pediatricians that simply missed the boat on this topic. 80% of kids can be cured of bedwetting way before 10 due to the underlying stool burden, and ignoring that rectal distention is not without consequences. Some children becoming so distended that they later need a cecostomy procedure to stay empty. this is a real problem, and it has been ignored for far too long, and i have the stories of stressed out parents and ill (due to neglect of their bowel/bladder issues) children to prove it. we need to truly diagnose (with xrays or other methods) these kids and treat them with any effective means, despite our feelings on the use any of the therapies, for the sake of these sick and suffering children. the rectum is supposed to be 2cm wide, the kids in my clinic have rectums from 6-10 cm wide stuffed full of stool. thats way more unnatural than using laxatives once in awhile, and its not going to be fixed with dietary changes, although once it is fixed the proper diet will prevent recurrence.

    • Very interesting reading Steve, and something that concerns me greatly. I have a 6yo boy with Aspergers who has been ‘withholding’ bowel movements on and off for 3 years now, we think due to his sensory issues (he hates the smell and sensation of bowel movements so avoids doing it at all). We’ve made huge changes to his diet and have seen great, positive improvements in his behaviour and general health, but the withholding continues. I’m certain that he must be suffering from rectal distention and the long term effects of this are very worrying for us as parents. I’ll be speaking with our health practitioner about having this diagnosed at our next appointment. Thank you 🙂

  • “Constipation does NOT arise from a laxative deficiency, I assure you, so treatment with those risky medicines are simply a band-aid that does not address the underlying dysfunction and long-term use can cause side effects and actually worsen the problem (and cause new ones)”

    The very sad things is that the above quote from the article can be carried over to most conditions.

    Besides the damaged gut and the probiotic imbalance that you mention, a lack of water and magnesium can also play a part in constipation.

    Also, medications far beyond laxitives and fiber are also prescribed. These include some that slow down the production of urine (this cannot be healthy AT ALL). There are others, but you get the idea.

    Great article! Thank you for sharing!

    Kevin :: Glycotrainer
    On Twitter: @glycotrainer
    Web Site: http://www.GlycoTrainer.com

  • “Constipation does NOT arise from a laxative deficiency, I assure you, so treatment with those risky medicines are simply a band-aid that does not address the underlying dysfunction and long-term use can cause side effects and actually worsen the problem (and cause new ones)”

    The very sad things is that the above quote from the article can be carried over to most conditions.

    Besides the damaged gut and the probiotic imbalance that you mention, a lack of water and magnesium can also play a part in constipation.

    Also, medications far beyond laxitives and fiber are also prescribed. These include some that slow down the production of urine (this cannot be healthy AT ALL). There are others, but you get the idea.

    Great article! Thank you for sharing!

    Kevin :: Glycotrainer
    On Twitter: @glycotrainer
    Web Site: http://www.GlycoTrainer.com

  • I am helping my friend with her 11 year old boy who has Aspbergers. He is homeschooled. I moved in 4 months ago . His room smelled like ammonia. He not only wet the bed at night, but would have accidents of urine and stool during the day. He is very high level intellectually so much of this seems to be behavioral. His schedule varies due to his erratic sleep schedule. When I arrived we got him a new mattress with vinyl cover, frequently reminded him to use the toilet and because he does his own laundry, informed him the washing machine is not a toilet bowl and had him start removing stool from his clothes prior to washing. There seemed to be greater than 90% improvement, but the past few weeks, there has been backsliding. We have tried talking to him about this and reinforcing toileting. Once asleep, he is almost impossible to wake. He seems to have regular bowel movements . He has been eating “clean” for a few years and I have introduced them to the concept of dairy free and gluten free but this has been inconsistent at best. Any suggestions?

  • I am helping my friend with her 11 year old boy who has Aspbergers. He is homeschooled. I moved in 4 months ago . His room smelled like ammonia. He not only wet the bed at night, but would have accidents of urine and stool during the day. He is very high level intellectually so much of this seems to be behavioral. His schedule varies due to his erratic sleep schedule. When I arrived we got him a new mattress with vinyl cover, frequently reminded him to use the toilet and because he does his own laundry, informed him the washing machine is not a toilet bowl and had him start removing stool from his clothes prior to washing. There seemed to be greater than 90% improvement, but the past few weeks, there has been backsliding. We have tried talking to him about this and reinforcing toileting. Once asleep, he is almost impossible to wake. He seems to have regular bowel movements . He has been eating “clean” for a few years and I have introduced them to the concept of dairy free and gluten free but this has been inconsistent at best. Any suggestions?

  • I also have problems with my son and constipation. It has been a nightmare. He has stool leakage often almost daily. I keep him on miralax and mineral oil to keep him regular. They have never did any real test to figure out how stretched his colon is. I think he gets busy hold it and then becomes cycle. Not only does he have this problem but he also wets the bed. He never has a dry night. He has a family history of this. His grandfather and uncle on his dad’s side also did this. I have tried the medication for the bed wetting to but did not help. I could go on and on. He also has ADHD and is on non stimulant med but on helps a little. He will be 7 end of the month so been dealing with along time. Seems hopeless at times. His own frustration is heart breaking. I don’t think he does this on purpose.

  • I also have problems with my son and constipation. It has been a nightmare. He has stool leakage often almost daily. I keep him on miralax and mineral oil to keep him regular. They have never did any real test to figure out how stretched his colon is. I think he gets busy hold it and then becomes cycle. Not only does he have this problem but he also wets the bed. He never has a dry night. He has a family history of this. His grandfather and uncle on his dad’s side also did this. I have tried the medication for the bed wetting to but did not help. I could go on and on. He also has ADHD and is on non stimulant med but on helps a little. He will be 7 end of the month so been dealing with along time. Seems hopeless at times. His own frustration is heart breaking. I don’t think he does this on purpose.

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