Friday, 11 March 2016

Bladder Control - Daytime Wetting that Happens in "Waves."

A 7 year-old girl came had daytime wetting that came in “waves.”

She stopped wearing a day and night diaper at 2.5 years. She tended to hold her pee to the last minute. Mom saw holding postures and she often needed to remind her daughter to pee. Her daughter was often in a rush to get to the bathroom but she made it on time and was usually either dry or had only minor drips in the underwear. 

Daytime wetting sufficient to change her clothes was not common. Mom reported that this degree of wetting came in “waves.” During the “waves” her daughter needed to change her clothes every day for several days up to a week.

The two common causes of intermittent daytime wetting that comes in “waves” are bladder infection and a change in the bowel health with solid poop pressing on the bladder.

She did not have any history of bladder infection and she did not have more specific symptoms of bladder infection during the “waves.” Her urine did not have infection when I checked.

Mom reported that her daughter had “severe” constipation at 18 months of age. Mom recollects “painful” and “traumatic” poops. The pain settled down and Mom presumed her bowel health was good. However, when I asked her daughter about her current poop pattern, she related that she only pooped twice a week and sometimes she went up to a week without a poop! Her poops were hard, up to two inches wide, and she routinely pushed, but she did not complain of any pain, and never talked about her poops with her Mom.

The family followed my instructions to achieve Bladder Friendly Bowel Health and by her follow up visit several months later she was pooping every day and the holding postures, urgency, and minor daytime dampness was gone. She had not experienced any "waves." 

This child has likely had poor bowel health since the age of 18 months. The “waves” of daytime wetting likely developed during those times when her bowel health was worse than usual.

The Mom had no idea about how infrequently her daughter pooped. At the follow up visit she told me, “We were lucky that she had the daytime wetting.” Otherwise they would never have realised the seriousness of the chronic bowel problem.

Besides “waves,” another word that families often use to describe the problem is “spurts.” Both words relate to water and are appropriate figures of speech to describe the problem.

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