Bedwetting - do I see a gastroenterologist or urologist?

[Anonymous]

Many say constipation should be ruled out first. Who do I take DS to see first? Any recommendations?

[Anonymous]

How old is he? Did the bedwetting just start, or has he always done it?

[Anonymous]

8.5, has always wet the bed at night, wet ms every night. Ped said he'll outgrow it but it's impacting him emotionally. We have tried bedwetting alarm 3 separate times, tried all other methods (no drinks after 7, waking him up throughout the night to pee, tonsils removed).

[Anonymous]

Get the book "It's No Accident" It explains how to deal with constipation as the cause of bedwetting. I would see a GI, and request an X-ray of the colon.

[Anonymous]

As we were trying to figure this out, I had my DD wear pullups at night. It saved the mattress. Withholding liquids does not really work to solve the underlying problem. Also, ensure that the last pee before he goes to bed is a complete emptying of the bladder. Most kids leave a bit of pee, so once he thinks he is done he should "squeeze, squeeze, squeeze" to ensure every bit is out. You may also try "bladder training". The bladder needs to be "stretched" to hold more. There is lots of info out there on the web. Good luck.

[Anonymous]

Thanks PP. yes we use pull-ups as well.

[Anonymous]

PP. Also, I've found that waking the child up during the night for them to go to the bathroom can be counter-productive. First, they are not "holding" the urine like they should be able to, and 2nd - they are not recognizing the sensation on their own. Somewhere is a "disconnect" between the bladder-brain thing. I remember waking up to take my DD to the bathroom at about 130am, and all it did was make me tired and angry in the mornings. If you do wake them, you have to be sure they are "completely" awake so they know what they are doing and can empty bladder completely. It also doesn't allow the bladder to expand to its capacity if you are emptying it during the evening.
Once you take them to the doctor, they will do various test - 24hour urine collection to determine the volume and to test for proteins and such along with blood tests to rule out diabetes or kidney diseases or anything else they may contribute to the problem.
Unfortunately, I let my DDs problem go on too long because I kept believing the doctors that she would outgrow it.

[Anonymous]

Thanks PP. We didn't do the waking up frequently, I was just throwing it out that we've tried about everything and are ready to see a doctor. So with your advise in assuming you recommend seeing a urologist? Do you have one in DC area you recommend?

[Anonymous]

Anonymous wrote:Thanks PP. We didn't do the waking up frequently, I was just throwing it out that we've tried about everything and are ready to see a doctor. So with your advise in assuming you recommend seeing a urologist? Do you have one in DC area you recommend?

Often times, they do say constipation. That wasn't the case with my DD. What is your primary care doc saying, other than he will outgrow it? Do they have an affiliation with a clinic/hospital? If you need a referral will he/she give you one to a specialist? Personally, I went straight to the urologist. I would try Children's Hospital. I know they have clinics throughout the area if the hospital in DC is not convenient.

Also, bedwetting does have a genetic link. I made the mistake of telling my DD that I wet the bed until I was 12yo and now she blames me. Oh well.

[Anonymous]

Pediatrician doesn't say anything other than wait it out. I'm having a hard time following that advice as its having an impact on him as he ages. No affiliation. I will look into Children's. Thanks

[Anonymous]

My son is 11. Our pediatrician also advised waiting it out, we tried the alarms and even the medication, which would work for a couple weeks then stop working.

We never suspected constipation, and his doctor never mentioned it, but we started giving him Miralax and much less bedwetting (50% improvement).

Now that we're on this path we were told that it may take a few months but it should solve the problem. In the meantime we're changing his diet to a much higher fiber one than before.

Basically we see a light at the end of the tunnel which is a relief.

[Anonymous]

Check out the WISH Clinic at CNMC
http://childrensnational.org/departments/wetting-infections-and-stooling-help-wish

[Anonymous]

Anonymous wrote:My son is 11. Our pediatrician also advised waiting it out, we tried the alarms and even the medication, which would work for a couple weeks then stop working.

We never suspected constipation, and his doctor never mentioned it, but we started giving him Miralax and much less bedwetting (50% improvement).

Now that we're on this path we were told that it may take a few months but it should solve the problem. In the meantime we're changing his diet to a much higher fiber one than before.

Basically we see a light at the end of the tunnel which is a relief.

Did you just start the miralax without an X-ray confirming constipation?

[Anonymous]

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.

[Anonymous]

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.