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Bedwetting and Constipation

Have you ruled out constipation?

Constipation can cause, or contribute to bedwetting

It can be very useful to get a good understanding of bowel movements and poop since it can impact bedwetting.

The information below will help you understand what to look out for, and what you can do to help your child.  Don’t be thrown by the word constipation.  People often say that their child isn’t constipated because he or she is regular.  However, constipation is more complex than that.  It is important to check that your child has healthy bowel movements and understand what to look out for.  

In the following text you will find out more about bowel movements, constipation, what type of stools are ideal, and what to do if your child is constipated.  You will also find a downloadable stool chart and poop diary.  I recommend that your child uses this for at least two weeks (you may have to complete it for your child).

Make sure your child isn't constipated, as even if they have no obvious symptoms, it can still affect bedwetting

Constipation is more complex than most people think and often misunderstood. Whilst pooping infrequently or passing tiny pellets can be a sign of constipation, incomplete bowel movements and carrying a faecal load (carrying a build-up of poo) is also an indication. Therefore, it isn’t always that easy to know if your child is constipated. If your child does suffer from constipation, it could be causing or increasing wet nights.

Constipation is relatively common in children. It isn’t usually serious, however if it lasts for a long time, it can lead to medical issues.

Constipation

Definition: Infrequent and frequently incomplete bowel movements.

How does constipation cause, or contribute to bedwetting?

Hard stools in the rectum can push against the bladder. If this happens the bladder won’t be able to hold as much urine.  If a child has been constipated for some time, the poo builds up in the rectum.  And this can cause the rectum to stretch, sometimes resulting in faecal incontinence.

Even past severe constipation can weaken the muscles that support bladder control, and that in itself can cause bedwetting. Luckily, there are exercises that can help strengthen these muscles again.

How will I know if my child is constipated?

Please Note!

Some children display no signs of being constipated, and yet they are!

What to look out for:-

  • Passing huge logs (bigger than an adult would pass, is an indication of constipation)
  • Passing hard, dry, lumpy stools
  • Passing small pellet-like stools
  • Passing watery poo (liquid poo might pass around the old poo that is stuck in the rectum)
  • Straining to go
  • Painful to pass
  • Avoiding going to the toilet
  • Occasional tummy pains
  • Bloated tummy
  • Pooping infrequently 
  • Having three or fewer bowel movements a week
  • Going more than twice a day

Faecal incontinence (Soiling & Encopresis)

It is common for children suffering from faecal incontinence to wet during the day and/or night.

They often have skid marks or poo in the pants and can have poop accidents.

If your child has faecal incontinence, it is advisable to go to your doctor for treatment.

Bedwetting solutions help children to wake up to pee

What is an ideal poop?

Please consult and print the Bristol Stool Chart below.  You will need this chart to complete your stool diary.  Type 3 and 4 stools are considered normal.  For the purposes of stopping bedwetting, it would be ideal to have type 4 stools (daily).  

Bristol-Stool-Chart
If you or your child completes this poop diary for two weeks you will get an indication of whether they are constipated or not.

How can I treat constipation?

What your child eats throughout the day, including snacks, matters a lot.  For the best approach, talk to a registered dietitian or nutritionist. Here are some general guidelines:-

  • Drink plenty of water (dehydration can contribute to constipation)
  • Eat a diet high in fibre (e.g. fruit, vegetables, beans, nuts, seeds)
  • Start to look at and notice the fibre content of foods
  • Exercise
  • Increase wholegrains (e.g. brown rice, popcorn, whole-wheat bread, whole-wheat pasta, quinoa)
  • Decrease refined grains (e.g. white flour, white rice, white bread – many cereals & biscuits)
  • Reduce junk food and sugary foods
  • Cow’s milk allergy or consuming too much dairy can lead to constipation
  • Flaxseed can help with constipation (easy to add to smoothies, salads, and cereal)
  • Prune juice and dried fruit can also help
  • Magnesium Citrate can be a good stool softer (consult your doctor)
  • Probiotics can help improve bowel regularity among other benefits
  • Exercises to strengthen the muscles and ligaments that support bladder and bowel control can also help

My child is still constipated - what can I do?

Make an appointment with your doctor and explain why you think your child is constipated.

If your child is still constipated, or, if you want to rule it out as a possible cause of bedwetting, it can be useful to ask your doctor for an x-ray.

An x-ray can show if there is a mass of stools pressing against the rectum. Paediatric Urologist, Dr Hodges, recommends asking to see the x-ray, and discuss it with your doctor so that he isn’t simply relying on the report of the radiologist.

If there is a mass of poo in the rectum, your doctor will help you treat it.  It can be useful to go back after a period of time to get another x-ray to see if the treatment has worked.

And finally...

Not all bedwetters are constipated.  However, it can be useful to get a good understanding of constipation and keep an eye on your child to ensure it isn’t an issue.

The brain and bladder won’t be able to send messages to each other effectively if the rectum is full of poop, or if the muscles that support bowel and bladder function have become weak. Urge sensation can be severely reduced and the ability for the bladder to hold wee to full capacity can also be reduced.

  • References and recommended reading:

  • https://www.healthline.com/health/cic/what-does-it-mean#:~:text=Constipation%20is%20defined%20as%20infrequent,hard%20or%20lumpy%20stool
  • https://raisingchildren.net.au/school-age/health-daily-care/toileting/faecal-incontinence
  • https://www.mayoclinic.org/diseases-conditions/constipation-in-children/symptoms-causes/syc-20354242
  • https://www.hopkinsmedicine.org/health/conditions-and-diseases/bladder-and-bowel-dysfunction
  • Its No Accident: Breakthrough Solutions To Your Child’s Wetting, Constipation, Uti’s And Other Potty Problems. Hodges, S & Schlosberg, S. 2012
  • End Bedwetting Now: A science-based, medically proven way to stop involuntary peeing and pooping. No Pills! No Equipment! No Cost! Professor Angel Garcia-Fernandez & Professor Peter Petros