Bedwetting (Nocturnal enuresis) can be a challenging condition for both the child and the parents. When looking into treatment options, there are several important factors to consider.
First, a diagnosis of enuresis is not typically made until the child is at least five year olds. Regressions in wetting are common up to this age, and often times are simply due to maturity.
Secondly, a determination between primary and secondary enuresis must be made.
- Primary Enuresis: (80%) The child has never been consistently dry. Causes can include faulty toilet training, maturational delays, congenital anomalies, small bladder capacity and allergies.
- Secondary enuresis: (20%) Incontinence recurs after 3-6 months of dryness. Causes can include trauma/subluxation, constipation, urinary tract infections, diabetes, genitourinary anomalies, medications, tumors and stress.
Once we determine the type of enuresis the child is struggling with, we will do a detailed history and physical exam to narrow in on potential causes. Because the bladder is neurologically innervated by multiple levels of the spine, close evaluation of the low back and sacral complex (triangle bone set at the bottom of the spine) is important. If your doctor feels it is necessary, referrals for other imaging or tests will be recommended.
Finally, sensitivities to foods/chemicals in the diet can also be linked to bedwetting. Through an Applied Kinesiology (AK) evaluation, your doctor will help you identify any foods that may be contributing to your child’s wetting. Often times dietary changes made to alleviate constipation can be incredibly helpful.