Constipation and Bedwetting:
Is There a Link?

child with constipation and bedwetting

When it comes to childhood bedwetting, one often overlooked but significant factor is constipation. Constipation and bedwetting are closely linked, with constipation frequently being a hidden cause of bedwetting in children. Ensuring that your child is not constipated is crucial, as treating it can often resolve or significantly improve bedwetting issues. 

Unfortunately, constipation is often misunderstood, leading to prolonged frustration for both children and parents. Recognizing the signs and implications of constipation can make a world of difference in managing bedwetting. Many parents may not realize that constipation can go beyond infrequent bowel movements; it can also involve hard stools, straining, or discomfort during bowel movements. Addressing these issues can alleviate pressure on the bladder, reducing the likelihood of bedwetting.

By understanding the strong link between constipation and bedwetting, parents can take proactive steps to ensure their child’s overall digestive health, paving the way for more restful nights and drier beds.

This article explores how constipation can lead to bedwetting and provides strategies for managing both conditions effectively.

What is Bedwetting?

Bedwetting, or nocturnal enuresis, refers to involuntary urination during sleep. It’s generally considered a concern if it persists beyond the age of seven as most children develop nighttime bladder control by this age. There are two types of bedwetting:

  • Primary Bedwetting: The child has never had a prolonged period of dryness at night.
  • Secondary Bedwetting: The child starts wetting the bed again after having been dry for at least six months.

Bedwetting can significantly impact a child’s self-esteem and may cause stress for both the child and their parents. Understanding the potential causes, such as constipation, is essential for effective management and support.

What is Constipation?

Constipation is characterized by infrequent, difficult, or incomplete bowel movements and can be categorized into two main types: acute and chronic.

Acute constipation: This is a temporary condition that often occurs suddenly and lasts only a few days. It can be triggered by changes in diet or routine, travel, moving, dehydration, lack of exercise, illness, or certain medications.

Symptoms typically include reduced bowel movements, hard stools, and difficulty during defecation. Acute constipation usually resolves with increased water intake, exercise, a high-fiber diet, and occasionally, short-term use of laxatives.

Chronic constipation: This is a long-lasting issue that persists for several weeks or more. It can be caused by ongoing factors such as a consistently poor diet, lack of physical activity, or underlying medical conditions like irritable bowel syndrome (IBS).

Chronic constipation can lead to complications such as fecal impaction, where stool becomes hard and difficult to pass.  It can also lead to encopresis, also known as fecal incontinence or soiling. 

Managing chronic constipation often requires long-term lifestyle changes, regular use of laxatives, and sometimes more intensive medical treatments to maintain bowel function.

Most children do not have a physical condition causing their constipation. Often, it’s due to diets high in refined carbohydrates like pasta, biscuits, rice, bread, and cereals, and low in fiber.

Children with special needs, such as autism or learning difficulties, may be more prone to constipation.

Additionally, chronic constipation in children can sometimes indicate a cow’s milk allergy, celiac disease, or gluten intolerance.

How Can You Tell if Your Child is Constipated?

Constipation is characterized by infrequent or difficult bowel movements. Common symptoms can include:

  • Hard, dry, lumpy stools
  • Lots of little poos in one go
  • Straining during bowel movements 
  • Painful bowel movements
  • Large stools that are hard to flush
  • Infrequent bowel movements (Ideally, a child should pass soft poo every day, or at least every other day) [13]
  • Soiling (poop or skid marks in pants)
  • Abdominal pain and bloating
  • Having more than 3 bowel movements a day
  • Swollen tummy
  • Frequent small wees or urgency
  • UTIs
  • Feeling sick or lack of appetite

Constipation can significantly impact bowel function, leading to discomfort and various complications, including bedwetting. It’s crucial to recognize and address constipation early to prevent these issues [1].

What is a Normal Bowel Movement Like?

Although the frequency varies from child to child, it is ideal to have a daily bowel movement (ERIC).  Stools should pass without significant straining or discomfort. 

The ideal stool should be wet, not too soft and not too hard, smooth, and easy to pass.  The Children’s Bowel and Bladder Charity (ERIC) has a wealth of information about constipation including this useful Poo Checker.

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The Link Between Bedwetting and Constipation

Constipation can contribute to bedwetting in several ways:

  • Pressure on the bladder: A full rectum can put pressure on the bladder, reducing its capacity and making it more likely for the child to wet the bed [2]. This pressure can sometimes cause small wees, urine leaks, or urinary urgency [13][14].
  • Interference with bladder signals: Constipation might interfere with the nerve signals between the bladder and the brain, making it harder for the child to recognize the need to urinate [3].
  • Weakening of pelvic floor muscles: Chronic straining due to constipation can lead to the weakening of the pelvic floor muscles. Additionally, long-term impaction can also contribute to this weakening, further complicating bladder control [14].

It’s important to note that not all cases of bedwetting are caused by constipation, but it is a common contributing factor.

Constipation is Often Undiagnosed

Many parents and doctors believe they can easily identify a child with chronic constipation. However, Dr. Hodges, a pediatric urologist, points out that even severe cases often go unnoticed.

A child can have regular bowel movements, pass normal-sized stools, and not complain of stomach pain yet still be constipated. Therefore, having your child undergo an X-ray to check for constipation might be the best way to rule it out as a contributing factor to bedwetting.

Treating Bedwetting Caused by Constipation

Addressing constipation can often resolve bedwetting. If your child has been wetting the bed for some time and you suspect they are constipated, it’s important to consult a doctor and request an x-ray to check for any blockages.

Here are some effective treatment options for bedwetting related to constipation:

  • Dietary Changes: Increasing both soluble and insoluble fiber intake with fruits, vegetables, and whole grains promotes regular bowel movements [7]. Foods rich in fiber help soften stools and make them easier to pass.
  • Hydration: Ensuring your child drinks plenty of water throughout the day helps prevent constipation by keeping the stool soft and easier to pass [8].
  • Exercise: Regular physical activity can promote healthy bowel movements [9].
  • Pelvic Exercises: In some children, weak muscles and ligaments in the pelvic area can contribute to constipation. Pelvic exercises can strengthen these muscles, improving the emptying of both the bladder and the bowel [15]
  • Toilet Positioning: Proper toilet positioning, such as sitting with feet flat on a stool and knees higher than hips, can reduce the strain on muscles during bowel movements.
  • Laxatives: Under the guidance of a doctor, laxatives like Movicol or Osmolax can be used to relieve constipation [10].  These medications help soften the stool and promote regular bowel movements. If the constipation keeps recurring, sometimes an enema-based regimen will work.
  • Natural Methods: Visit your health food shop or pharmacy for advice. Pear juice, probiotics, flaxseeds, chia seeds, and magnesium citrate are natural remedies for constipation.

By addressing constipation with these methods, you can help reduce or eliminate bedwetting in your child, leading to more restful nights and improved overall health. Please note that keeping constipation away can be as challenging as getting rid of it in the first place.

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Additional Tips and Resources

In addition to treating constipation, here are some tips for managing bedwetting:

  • Toilet Routine: Establish a regular toilet routine, especially before bedtime, to ensure the child empties their bladder [12]. Regularly holding in stools can lead to constipation, so encourage your child to empty their bowels when they feel the urge. You may also need to privately discuss your child’s needs with their teacher to ensure they can go to the bathroom as needed.
  • Bedwetting Program: Consider enrolling in the Stay Dry at Night Bedwetting Program, which offers a holistic and gentle approach to managing bedwetting. This multifaceted program not only helps in building effective brain-bladder communication but also provides in-depth knowledge about the factors contributing to bedwetting and their solutions.

Conclusion

Constipation can significantly contribute to bedwetting by decreasing bladder capacity and disrupting bladder control signals. Addressing constipation through proper diet, hydration, exercise, and medical guidance can often alleviate bedwetting issues. 

Ready to help your child overcome bedwetting? Learn more about our gentle and effective Bedwetting Program or sign up today to get started.

References:

  1. Mayo Clinic. (n.d.). Constipation in children. Retrieved from Mayo Clinic
  2. (n.d.). Constipation in children. Retrieved from NHS
  3. Hodges, W. (n.d.). Bedwetting and Accidents. Retrieved from Bedwetting and Accidents
  4. Moffatt, M. E. K. (2008). Nocturnal enuresis: Psychosocial implications and management. Pediatric Drugs, 10(4), 213-218. DOI: 10.2165/00148581-200810040-00003
  5. Robson, W. L. (2009). Clinical practice: Evaluation and management of enuresis. The New England Journal of Medicine, 360(14), 1429-1436. DOI: 10.1056/NEJMcp0804877
  6. Caldwell, P. H., Deshpande, A. V., & von Gontard, A. (2013). Management of nocturnal enuresis. BMJ, 347, f6259. DOI: 10.1136/bmj.f6259
  7. Joinson, C., Heron, J., Butler, R., & von Gontard, A. (2006). Psychological differences between children with and without nocturnal enuresis. The Journal of Urology, 176(1), 205-210. DOI: 10.1016/S0022-5347(06)00378-9
  8. Von Gontard, A., & Nevéus, T. (2006). Management of disorders of bladder and bowel control in childhood. Springer.
  9. Butler, R. J., & Holland, P. (2000). The three systems: A conceptual way of understanding nocturnal enuresis. Scandinavian Journal of Urology and Nephrology. Supplementum, 206, 9-12. DOI: 10.1080/030088800750287389
  10. Hodges, W. (n.d.). Bedwetting and Accidents. Retrieved from Bedwetting and Accidents
  11. Mayo Clinic. (n.d.). Bedwetting in children. Retrieved from Mayo Clinic
  12. (n.d.). Bedwetting in children. Retrieved from NHS
  13. The Children’s Bowel and Bladder Charity (2024) Advice for children with constipation
  14. Faecal Incontinence, Constipation. Retrieved from Continence Foundation of Australia
  15. Peter Petros et al.. 2019. End Bedwetting Now: A Science-Based, Medically Proven Way to Stop Involuntary Peeing and Pooping. No Pills! No Equipment. Golden Wren Publishing Pty Ltd.

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