See below blog our Senior Physio Liz Crisp did for DRI Sleeper
There are many different types of experts who can help children deal with persistent bedwetting. To learn more about these modalities, DRI Sleeper has asked Liz Crisp, a Physiotherapist based in Melbourne, Australia, to write this guest blog on how a Paediatric Continence Physio approaches bedwetting in children.
Bed-wetting, or Nocturnal Enuresis, is a common, often frustrating, and sometimes confusing condition that can be treated very effectively when the mechanisms behind the incontinence are understood. Enuresis is defined as ‘involuntary micturition (wees) occurring at night while asleep in a child aged five years or more’. Statistics tell us that almost one in every ten children aged 6-7 wets the bed, so it is super important to remember this and reassure your child that it is not their fault. There is a lot that can be done, and we Physios love working with kids and parents to have dry nights!
I believe it is imperative to always look at the big picture when treating Enuresis. To help build a strong therapist-patient relationship and work positively towards successful treatment outcomes, I always start by getting to know the child in front of me and build rapport so we can make the sessions fun and take away the stigma or negativity associated with bed-wetting. I want to know who lives at home with them, what their interests and favourite activities are, what their diet is like, how much water they drink and how many times a day or a week they do a poo. This helps me to understand their motivators, their habits and try to gauge whether the bowels are a contributor to their presentation. More often than not, constipation is the biggest cause of enuresis, and it is quite astounding how much poo children can do when all of the stars (fibre, fluid intake, good bowel emptying routine) align!
Once I have taken a thorough history, I will then look at the abdomen using an ultrasound machine to ascertain whether constipation is the primary issue or whether there are any other possible contributors, such as the bladder capacity or pelvic floor tension. I’ll often then request a bowel and/or bladder diary to be completed and then review this in the next session, allowing us to make any necessary changes to fluid intake, consumption/drinking habits and fibre intake. If, after managing the constipation, the night-time accidents persist, we will look at other options such as timed voiding, timed sits to empty the bowels and a bed-wetting alarm which has been shown to assist with persistent nocturia in most cases between 6-12 weeks.
There are SO many treatment options for managing nocturnal enuresis once the underlying cause(s) has been identified. If you have any concerns about your child's toileting, reach out to your local Paediatric Continence Physio. Wishing you many more restful nights of sleep and success with overcoming night-time accidents!
Liz Crisp
Senior Physiotherapist (Grad Cert. Physio in Pelvic Health)