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Bedwetting can be due to undiagnosed constipation, research shows
Date:1/27/2012

recommend asking children and their parents if the child's bowel movements occur irregularly (less often than every other day) and if the stool consistency is hard.

"These questions focus on functional constipation and cannot help identify children with rectums that are enlarged and interfering with bladder capacity," said Hodges. "The kind of constipation associated with bedwetting occurs when children put off going to the bathroom. This causes stool to back up and their bowels to never be fully emptied. We believe that treating this condition can cure bedwetting."

Children in the study ranged from 5 to 15 years old. The constipated children were treated with an initial bowel cleanout using polyethylene glycol (Miralax), which softens the stools by causing them to retain water. In children whose rectums remained enlarged after this therapy, enemas or stimulant laxatives were used.

Hodges cautioned that any medical therapy for bedwetting should be overseen by a physician.

The study used abdominal X-rays to identify the children with excess stool in their rectums. Hodges and radiologists at Wake Forest Baptist developed a special diagnostic method that involves measuring rectal size on the X-ray. He said rectal ultrasound could also be used for diagnosis.

"The importance of diagnosing this condition cannot be overstated," Hodges said. "When it is missed, children may be subjected to unnecessary surgery and the side effects of medications. We challenge physicians considering medications or surgery as a treatment for bedwetting to obtain an X-ray or ultrasound first."

The study involved reviewing the charts of 30 consecutive patients treated for bedwetting. The authors cautioned that some cases may have improved on their own over time. They said a more accurate measure of the treatment's success would be to randomly assign constipated children to laxative therapy or an inactive therapy, an approach that would id
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Contact: Karen Richardson
krchrdsn@wakehealth.edu
336-716-4453
Wake Forest Baptist Medical Center
Source:Eurekalert

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