When we think about bedwetting, the first things that might come to mind are age, developmental stages, or even stress. However, there’s another surprising factor that could be playing a role: constipation. If you’re a parent or caregiver whose child is struggling with wet nights, understanding this connection could help in addressing both issues more effectively.
The Hidden Link: How Constipation Affects Bedwetting
Typically, constipation occurs when a child has infrequent, difficult, or painful bowel movements, often accompanied by hard, dry stools. In some cases, constipation can be severe enough that it interferes with daily life. But did you know that it can also affect the bladder and contribute to bedwetting (nocturnal enuresis)?1
Here’s how it works:
- Pressure on the Bladder: When a child is constipated, their large intestine (colon) becomes full of poop. This can put pressure on the bladder, which is located near the colon in the pelvis. The increased pressure can make it difficult for the bladder to fully empty. It can also interrupt the signal that it’s time to wake up and use the bathroom, leading to bedwetting.2
- Disrupted Bladder Function: Chronic constipation can cause changes in the way the bladder functions. The stretching of the colon can interfere with the nerves that control the bladder, making it harder for the child to hold urine overnight.
- Dehydration and Irritation: Constipation can also lead to dehydration, especially if the child is not drinking enough fluids to help ease bowel movements. Dehydration can make the urine more concentrated, irritating the bladder and increasing the likelihood of bedwetting incidents. The American Academy of Pediatrics (AAP) states that proper hydration is essential for preventing both constipation and bladder irritability, which can improve nighttime bladder control.3
What Can Parents Do?
If your child is experiencing both constipation and bedwetting, there are a few strategies that can help tackle both problems:
- Focus on Healthy Bowel Movements: Make sure your child is eating a fiber-rich diet (fruits, vegetables, whole grains) and drinking plenty of water. This can help prevent constipation and ease discomfort.4 Regular bathroom habits are also important—encourage your child to use the bathroom regularly during the day to avoid stool buildup.
- Work with a Pediatrician: If the constipation and bedwetting persist, it’s a good idea to speak to a pediatrician. Sometimes, chronic constipation may need to be treated with medication or a more structured bowel training program. A pediatrician can also rule out any underlying issues that might be contributing to the bedwetting.
- Work with a Pediatric Pelvic Health Physical Therapist: Chronic constipation is often more complicated than eating more fruits and veggies. Sometimes, children are constipated because they are afraid to poop. As a result, they start to hold in their bowel movements, clenching their pelvic floor muscles to resist the urge. Over time, this creates tight, dysfunctional pelvic floor muscles. This, combined with poor toileting posture and other factors, makes pooping even more difficult, which makes the constipation worse. A pediatric pelvic health PT can help your child break this vicious cycle with exercise, body awareness training, and lifestyle changes.
- Practice Patience and Understanding: Both constipation and bedwetting can be frustrating for parents and children alike. It’s important to be patient and offer reassurance. Avoid punishment or negative reinforcement for bedwetting incidents, as this can create anxiety that might make the problem worse. According to the American Academy of Pediatrics, a calm, supportive approach is key to addressing bedwetting in children.
What if I don’t think my child is constipated?
If you read this and thought, “But my kiddo poops everyday! They can’t be constipated!” you aren’t alone. Many parents don’t realize their child is constipated because it is not always easy to identify. A child could be pooping every day and still have a large backup of stool stuck in their rectum. In fact, some sources estimate that anywhere from 30-50% of children with constipation have daily bowel movements. If you don’t think your child is constipated, but they are still wetting the bed, you may want to consider ruling out constipation with a type of imaging called a KUB.
A KUB (Kidneys, Ureters, and Bladder) X-ray is a useful tool doctors can use to check for constipation in children, especially when it’s been going on for a while or isn’t easy to spot during an exam. This type of X-ray shows how much stool is sitting in the large intestine, which can help confirm if constipation is part of the problem. A KUB X-ray isn’t needed for every child, but it can be helpful when the signs of constipation aren’t clear or when treatments don’t seem to be working. If you want to rule out constipation, talk to your pediatrician about this low-risk test.
The Takeaway
If your child struggles with both constipation and bedwetting, it’s important to understand the potential connection between the two. Be sure to consult with your pediatrician for guidance and support in creating a plan that works for your child. With the right approach, it’s possible to manage both conditions effectively, helping your child feel more comfortable and confident at night.
References:
- Yazdani, H., et al. (2020). “The Relationship Between Constipation and Urinary Incontinence in Children.” Journal of Urology. 204(5): 1037-1044. DOI: 10.1097/JU.0000000000000994 ↩︎
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2021). “Constipation in Children.” Retrieved from https://www.niddk.nih.gov ↩︎
- American Academy of Pediatrics (AAP). (2019). “Bedwetting (Nocturnal Enuresis).” Pediatrics. Retrieved from https://www.aap.org ↩︎
- Mayo Clinic. (2020). “Childhood Constipation.” Retrieved from https://www.mayoclinic.org ↩︎
But first, Pelvic Health. 