Bedwetting and Chiropractic

Bedwetting and Chiropractic

Bedwetting and the Chiropractic Approach

            There are many different childhood diseases that can make life difficult, not only for the child but the parents as well.  Among these disease we have bedwetting, which is a very common problem, it influences somewhere between five and six million kids.  The dilemma of bedwetting can cause a child to have less self confidence, a feeling of failure and embarrassment.  As children reach the ages of 6 and 7 they start sharing their lives with different friends and family, and sometimes have to hide this humiliation of a disease and keep it a secret in fears of ridicule.  Making different arrangements for sleepovers, sleeping on plastic sheets or trying to fit in oversize diapers, these are just some of the life adjustments kids may have to face.  At this age children can be very vulnerable and lose their self confidence, creating the parents to do anything possible to help their child. 

Most often parents will look towards taking different medication for the problem, which may or may not help the child stay dry at night.  However, this is just hiding the cause of the disease and the child may have to take medication for years and the meds may never work for the child either.  Until their body finally develops a correct urinary retention reflex is when the problem can be ultimately fixed.  What if there was a solution that could relieve your child of chronic medication? Would parents choose it?  Most likely they would if they were educated on the influence of what some medications have on a young developing body.  Chiropractic care seems to be the choice by parents after everything seems to have failed.  It should be the first choice because it is a healthy and safe approach to the child’s wellness and it will in most cases stop the problem, rather than waiting for the child to grow out of it.

            There are two different types of bedwetting, either primary or secondary nocturnal enuresis.  In primary nocturnal enuresis there is wetting at least twice a month and the child has never achieved complete nighttime control.  Secondary enuresis is related either: to a new psychological stress, such as divorce or a death in the family or something physical such as diabetes or a urinary tract infection, or even a situational change such as altered eating and sleeping habits.  The primary enuresis is the most common but the most uneducated to parents.  A survey was conducted by the ICR survey group in July 10, 1996 through August 6, 1996 of 9000 parents[1].  The survey found that 22% of parents thought bedwetting was due to laziness.  A research study has shown that primary enuresis is majority of the time inherited by an autosomal dominant gene called ENUR.  When both parents were bed-wetter 77% of their children were also, if only one parent was 44% chance their child will also be.  If neither parent was a bed-wetter than a 15% chance their child would be.

            Although the ENUR gene has been speculated to be the cause of whether a child can wake up to go urinate or not, it doesn’t mean that we need to wait until the child grows out of it.  The chiropractic approach has customarily adjusted the spine in the lumbar or sacrum.  As we know that the emptying of the bladder is controlled by the detrusor and trigone muscles, which are innervated by the S3 to S4 via the parasympathetic system.   Bladder function is also controlled by the urogenital diaphragm supplied by L2 spinal nerve.  If the phrenic reflex is just merely immature or underdeveloped then time can only help.  However, if the reflex is fully developed it may be obstructed by a spinal subluxations, which would prevent the correct sleeping process.  Since the sacrum is under developed and the five segments are not fully fused until the age of 20, it is very vulnerable to injury.  At this period of development the sacrum is subject to repeated falls as the infant begins to learn to walk. The early trauma to the sacrum could possibly be the grounds of why bedwetting stops after the spine is adjusted.

            While adjustments of the spine in the bed-wetter have had great results in resolving the problem, one study from Australia disagreed[2].  They concluded that spinal adjusting had little influence on enuresis.  A second study from Australia had different results, and discovered great results[3].  With two studies determining opposite results, one could suggest that there are several causes to bedwetting and one is spinal related. 

There are several studies published in the Journal of Manipulative and Physiological Therapeutics showing good results with the influence on adjustments and bedwetting.  A study[4] of 171 children who suffer from enuresis and averaged 7 nights of bed wetting per week were looked at.  After chiropractic treatment there was an average drop to 4 nights a week of bed wetting.  Outstanding enough 25% of the children had bed wetting reduction of 50% and 15% of the children were considered dry.

In addition, another study[5] was developed with 46 enuretic children, 31 placed under chiropractic care and 15 were in the control group receiving no care.  Close to 18% decreased in bed wetting in the chiropractic group and none had changed in the control grouped.  Shockingly, some kids were considered dry after the first adjustment.

There is lots of information providing evidence that chiropractic care can help those with enuresis caused by spinal subluxations.  On the other hand the percentages are relatively low concluding that there are other influential causes that create children to bed wet.  The majority of the general public moves to treating their children with medication. The top three meds given to those who bed wet are Sanofiaventis, Tofranil and Ditopan.  These three medications have some major side effects that some parents are not aware of such as a few listed: nosebleeds, headaches, stomach pain, seizures, blurred vision, low blood pressure, insomnia, personality changes, abdominal pain, nervousness, UTI, and asthma. 

The first step and the most natural healthiest step, is to bring your child to a chiropractor and have a consultation and exam done on the child to help identify any subluxations that might be causing the nerve interference.  If the adjustments do not help, there are other approaches the child can try such as the bed wetting alarm system which will wake the child up on a scheduled plan to help the child’s body to develop urination pattern.  A child should also be monitor on how much liquid he or she drinks two hour before bed.  By decreasing the amount of liquid the child drinks before nighttime will help decrease the amount of urine production at night.  Also check to see if the child is taking any diuretic medicine which would directly increase urine output.  And on that note, monitor the consumption of diuretic beverages such as caffeinated cola drinks and chocolate.  Another strategy that may help the child to overcome bed wetting is to allow them to have at least 30 minutes of extra sleep each day, which will aid in keeping them out of such a deep sleep.

Sometimes it can be the parents that cause part of the problem.  The kids may be drinking too much water.  In today’s society water is being pushed to adults more and more than ever, especially with the bottle water era.  The daily water intake of 64ozs for adults should not be the forced to the child, which most parents mistakenly do.  Children only need half of an adult’s water intake.  Also if a child is only wetting the bed on certain days, it may be good to take a diary of what the child is eating and drinking on those days.  If the kid is only wetting the bed on Fridays, then look at what he is eating on Fridays.  Is the family watching a movie and eating a lot of popcorn which in turn causes the child to drink more soda or did the child come back from a sports practice and rehydrate with a large Gatorade.  All and all if a child is bedwetting there are many different approaches a parent can do and choose before resulting to medication, which may not work either.

 For information on this please see our website at www.twinschiropractic.com or contact a doctor at 612-968-9807

Cheers,

Dr. Daniel Clements D.C.

Bibliography

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[1]Greene, Alan MD.  2001.  Fast Facts about Bed Wetting. http://www.drgreene.com/fact/fast-facts-about-bed-wetting

[2] LeBoeuf Leboeuf C, Brown P, Herman A, Leembruggen K, Walton D, Crisp TC. Chiropractic care of children with nocturnal enuresis: a prospective outcome study. Journal Of Manipulative And Physiological Therapeutics. 1991 February;14(2):110–115.

[3] Gemmell and Jacobson: Chiropractic Management of Enuresis. JMPT, 12(5):1989.

[4] Leboeuf C, Brown P, Herman A, Leembruggen K, Walton D, Crisp TC. Chiropractic care of children with nocturnal enuresis: a prospective outcome study. Journal Of Manipulative And Physiological Therapeutics. 1991 February;14(2):110–115.

[5] Reed WR, Beavers S, Reddy SK, Kern G. Chiropractic management of primary nocturnal enuresis. Journal Of Manipulative And Physiological Therapeutics. 1994;17(9):596–600.