Bedwetting - do I see a gastroenterologist or urologist?

[Anonymous]

Anonymous wrote:The first thing to do is get an x-ray. If his colon is backed up, he is constipated. I wouldn't put him on any medication before doing that. You can do the x-ray through your pediatrician. If he is constipated, see a GI specialist. I took our child to a urologist due to similar issues, but he wouldn't do anything until the constipation is cleared up.

+1

[Anonymous]

Anonymous wrote:The first thing to do is get an x-ray. If his colon is backed up, he is constipated. I wouldn't put him on any medication before doing that. You can do the x-ray through your pediatrician. If he is constipated, see a GI specialist. I took our child to a urologist due to similar issues, but he wouldn't do anything until the constipation is cleared up.

I would seriously hope a pediatrician would not just order an x-ray. First, there is no signs of constipation but bed wetting which isn't really a sign. How about distended abdomen. Abdominal pain, poor appetite, hyper/hypo active BS. Diarrhea or hard stool, nausea/vomiting. Second, an x-ray may show a bowel obstruction but may not show minor constipation. Third, a physician needs more history, or at least they should before subjecting a child to unnecessary radiation.

[Anonymous]

Op, is there any family history of bedwettng? My DS wet the bed until age 8, when we finally had success with the alarm. My father wet the bed until puberty, and my brother was a bed wetter as well (although stopped before puberty), so I wasn't shocked to see it in one of my kids.

FWIW, we used the alarm for about 2 weeks before we started to see progress. The first nights, that alarm would be screaming right under DS's chin (pinned to his pajama top) and vibrating so hard it shook the bed, but he was not awakened. When I ran into DS's bedroom, I would fnd him sleeping like a baby. So bizarre.

[Anonymous]

It could be a food allergy. Milk and gluten, if he is allergic to those, will irritate the lining of the bladder and make him pee.

[Anonymous]

Do not go to the clinic at Childrens. The NP shamed my child. Seriously awful experience.

[Anonymous]

Anonymous wrote:

Anonymous wrote:The first thing to do is get an x-ray. If his colon is backed up, he is constipated. I wouldn't put him on any medication before doing that. You can do the x-ray through your pediatrician. If he is constipated, see a GI specialist. I took our child to a urologist due to similar issues, but he wouldn't do anything until the constipation is cleared up.

I would seriously hope a pediatrician would not just order an x-ray. First, there is no signs of constipation but bed wetting which isn't really a sign. How about distended abdomen. Abdominal pain, poor appetite, hyper/hypo active BS. Diarrhea or hard stool, nausea/vomiting. Second, an x-ray may show a bowel obstruction but may not show minor constipation. Third, a physician needs more history, or at least they should before subjecting a child to unnecessary radiation.

Plus just give him prunes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:The first thing to do is get an x-ray. If his colon is backed up, he is constipated. I wouldn't put him on any medication before doing that. You can do the x-ray through your pediatrician. If he is constipated, see a GI specialist. I took our child to a urologist due to similar issues, but he wouldn't do anything until the constipation is cleared up.

I would seriously hope a pediatrician would not just order an x-ray. First, there is no signs of constipation but bed wetting which isn't really a sign. How about distended abdomen. Abdominal pain, poor appetite, hyper/hypo active BS. Diarrhea or hard stool, nausea/vomiting. Second, an x-ray may show a bowel obstruction but may not show minor constipation. Third, a physician needs more history, or at least they should before subjecting a child to unnecessary radiation.

Studies show that constipation in children do not always present symptoms.

http://www.m.webmd.com/children/news/20120130/study-constipation-may-cause-bedwetting

[Anonymous]

Anonymous wrote:Op, is there any family history of bedwettng? My DS wet the bed until age 8, when we finally had success with the alarm. My father wet the bed until puberty, and my brother was a bed wetter as well (although stopped before puberty), so I wasn't shocked to see it in one of my kids.

FWIW, we used the alarm for about 2 weeks before we started to see progress. The first nights, that alarm would be screaming right under DS's chin (pinned to his pajama top) and vibrating so hard it shook the bed, but he was not awakened. When I ran into DS's bedroom, I would fnd him sleeping like a baby. So bizarre.

My DH wet until 6 or so. Bedwetting alarm part 3 under way (4 days in). We moved his mattress into master bedroom so I can help him when it goes off.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The first thing to do is get an x-ray. If his colon is backed up, he is constipated. I wouldn't put him on any medication before doing that. You can do the x-ray through your pediatrician. If he is constipated, see a GI specialist. I took our child to a urologist due to similar issues, but he wouldn't do anything until the constipation is cleared up.

I would seriously hope a pediatrician would not just order an x-ray. First, there is no signs of constipation but bed wetting which isn't really a sign. How about distended abdomen. Abdominal pain, poor appetite, hyper/hypo active BS. Diarrhea or hard stool, nausea/vomiting. Second, an x-ray may show a bowel obstruction but may not show minor constipation. Third, a physician needs more history, or at least they should before subjecting a child to unnecessary radiation.

Studies show that constipation in children do not always present symptoms.

http://www.m.webmd.com/children/news/20120130/study-constipation-may-cause-bedwetting

One article on webmd isn't going to get a ped to write a script for an X-ray. Most bed wetting is a form of a sleep disorder, not constipation. And constipation can be dealt with before going to any doctor. Bowel regimen, a log of bowel movements with amount and type, along with urine/bed wetting log. This would see if there are any possible correlation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The first thing to do is get an x-ray. If his colon is backed up, he is constipated. I wouldn't put him on any medication before doing that. You can do the x-ray through your pediatrician. If he is constipated, see a GI specialist. I took our child to a urologist due to similar issues, but he wouldn't do anything until the constipation is cleared up.

I would seriously hope a pediatrician would not just order an x-ray. First, there is no signs of constipation but bed wetting which isn't really a sign. How about distended abdomen. Abdominal pain, poor appetite, hyper/hypo active BS. Diarrhea or hard stool, nausea/vomiting. Second, an x-ray may show a bowel obstruction but may not show minor constipation. Third, a physician needs more history, or at least they should before subjecting a child to unnecessary radiation.

Studies show that constipation in children do not always present symptoms.

http://www.m.webmd.com/children/news/20120130/study-constipation-may-cause-bedwetting

One article on webmd isn't going to get a ped to write a script for an X-ray. Most bed wetting is a form of a sleep disorder, not constipation. And constipation can be dealt with before going to any doctor. Bowel regimen, a log of bowel movements with amount and type, along with urine/bed wetting log. This would see if there are any possible correlation.

It's not just a web md article, it was a study done by Steve Hodges and published by the Journal of Urology. Do you have research that shows most bedwetting is sleep disorder? Also you don't need Ped to write Rx for xray, you can go directly to GI. Again, most children with constipation don't show any symptoms so logs aren't going to do anything.

http://www.wakehealth.edu/Urology/Pediatric/Bedwetting-Can-be-Due-to-Hidden-Constipation-Research-Shows.htm

[Anonymous]

Anonymous wrote:If your son was always wetting the bed how could it be an infection or constipation?

My daughter had constipation and then a a partial bowel obstruction at age 5. Side effects are usually stomach pains, dry heaving, various forms of stool (sometimes liquid, the poop never being wide, hard and solid, etc..) Anyway, she never once wet the bed.

There has only been one study done in 2011 that mentions constipation and wetting the bed. If your child has normal bowel movements and poops regularly (which you should look into if you haven't) getting him on Miralax or something else will not help and could his bowels addicted/ immune to such medicine. Plus if you go to a gastro the FIRST thing they will tell you to do is do a 10 day bowel history and come back. And a ped can check for constipation with an abdominal check.

Have you checked him while he is sleeping? Some bedwetting is caused by enlarged tonsils or sleep apnea. Some from diabetes, some from a sleep disorder, some from allergies.

I think your best bet is to do a urinalysis, urine culture, abdominal palpations at pediatrician, 10 day bowel history, check him in his sleep for snoring/apnea, and find out if he is peeing around the same time each night (60-90min after falling asleep precisely) which can mean sleep disorder. It might mean you have a lack of sleep a few days but if you really want to look into a specialist, you have to have all your eggs in one basket.

I know you say your DD was constipated and had a bowel obstruction but you really have shallow knowledge of constipation, the research that's been done since the 70s and it's relationship to bedwetting. Constipation isn't just infrequent or hard bowel movements, it is also the failure of the bowels to fully empty. The longer feces stay in the GI tract, the drier, harder they become - they become a 'fecal load'. This load is not always detectable on physical examination (my DS's wasn't and he was examed by multiple specialists) which is why an X-ray is required to confirm. We did the poop log with my DS and it should that he pooped every day at least once and it was of soft consistency. We even did a couple of 'cleanout regimes' Yet he was still constipated - meaning he had a significant fecal load that did not clear/pass.

You also know very little about products such as Miralax. It is not addicitve (again, I'm astounded that your DD suffered from constipation and a partial obstruction). Even if it were, you still have to address the constipation issue - and prunes are a joke when you're talking about fecal load. How else do you clear the fecal load without drawing more water into the bowels to loosen the compaction? In our case, we not only did massive doses of Miralax over a weekend but also had to give enemas. DS and I both knew when he had cleared the load, it was like pooping a baseball (okay, not really that big but astounding in it's size, hardness and roundness).

It was my pediatrician who recommended It's No Accident http://www.bedwettingandaccidents.com/ . It was eye opening and really helped us understand constipation is a lot more than what we thought it was. Remember Zoe the girl who was kicked out of preschool because of too many accidents? https://www.washingtonpost.com/blogs/on-parenting/post/what-happened-to-zoe-rosso-the-toddler-who-got-kicked-out-of-school-for-too-many-accidents/2012/05/16/gIQAsoi3TU_blog.html

[Anonymous]

Anonymous wrote:

Anonymous wrote:If your son was always wetting the bed how could it be an infection or constipation?

My daughter had constipation and then a a partial bowel obstruction at age 5. Side effects are usually stomach pains, dry heaving, various forms of stool (sometimes liquid, the poop never being wide, hard and solid, etc..) Anyway, she never once wet the bed.

There has only been one study done in 2011 that mentions constipation and wetting the bed. If your child has normal bowel movements and poops regularly (which you should look into if you haven't) getting him on Miralax or something else will not help and could his bowels addicted/ immune to such medicine. Plus if you go to a gastro the FIRST thing they will tell you to do is do a 10 day bowel history and come back. And a ped can check for constipation with an abdominal check.

Have you checked him while he is sleeping? Some bedwetting is caused by enlarged tonsils or sleep apnea. Some from diabetes, some from a sleep disorder, some from allergies.

I think your best bet is to do a urinalysis, urine culture, abdominal palpations at pediatrician, 10 day bowel history, check him in his sleep for snoring/apnea, and find out if he is peeing around the same time each night (60-90min after falling asleep precisely) which can mean sleep disorder. It might mean you have a lack of sleep a few days but if you really want to look into a specialist, you have to have all your eggs in one basket.

I know you say your DD was constipated and had a bowel obstruction but you really have shallow knowledge of constipation, the research that's been done since the 70s and it's relationship to bedwetting. Constipation isn't just infrequent or hard bowel movements, it is also the failure of the bowels to fully empty. The longer feces stay in the GI tract, the drier, harder they become - they become a 'fecal load'. This load is not always detectable on physical examination (my DS's wasn't and he was examed by multiple specialists) which is why an X-ray is required to confirm. We did the poop log with my DS and it should that he pooped every day at least once and it was of soft consistency. We even did a couple of 'cleanout regimes' Yet he was still constipated - meaning he had a significant fecal load that did not clear/pass.

You also know very little about products such as Miralax. It is not addicitve (again, I'm astounded that your DD suffered from constipation and a partial obstruction). Even if it were, you still have to address the constipation issue - and prunes are a joke when you're talking about fecal load. How else do you clear the fecal load without drawing more water into the bowels to loosen the compaction? In our case, we not only did massive doses of Miralax over a weekend but also had to give enemas. DS and I both knew when he had cleared the load, it was like pooping a baseball (okay, not really that big but astounding in it's size, hardness and roundness).

It was my pediatrician who recommended It's No Accident http://www.bedwettingandaccidents.com/ . It was eye opening and really helped us understand constipation is a lot more than what we thought it was. Remember Zoe the girl who was kicked out of preschool because of too many accidents? https://www.washingtonpost.com/blogs/on-parenting/post/what-happened-to-zoe-rosso-the-toddler-who-got-kicked-out-of-school-for-too-many-accidents/2012/05/16/gIQAsoi3TU_blog.html

I agree with the above poster. I don't know why you think there's only been on study done but the relationship between constipation and incontinence has been documented since the 60s. You need a subscription to PubMed to access the papers but just looking at the list of studies shows there has been a lot of research. Not sure why it's not better known..... http://www.ncbi.nlm.nih.gov/pubmed?cmd=Link&db=pubmed&dbFrom=PubMed&from_uid=5790623

[Anonymous]

Most bed wetting is caused by a food allergy. True for adults, too -- some adults wet the bed. Milk is a good suspect.

[Anonymous]

Our ped would not order an X-ray.

[Anonymous]

Anonymous wrote:Most bed wetting is caused by a food allergy. True for adults, too -- some adults wet the bed. Milk is a good suspect.

Can you provide a link to research supporting this assertion? Thanks.