I had a follow up appointment with a dear little 8 year old yesterday and thought I would share a little about her story in case it helps you too!
Josie has been doing really at being dry at night since I saw her a year ago and they implemented my bladder and bowel program. Most months she isn’t wet at all, and if she is ever wet, it’s a once off. This school holiday however, she went to stay at her cousins house (without her Parents there) and wet the bed 4 nights in a row. Her Mother was really surprised and concerned by this and booked her in for a follow up with me to try and ascertain why. Since she returned home from the week long visit; she has also been wet twice in the past 2 weeks after being dry for weeks before that.
Upon chatting to Josie, it was really simple to establish why. With all the busy-ness and fun involved with staying with her cousins and the change in her usual routine, she hasn’t been pooping daily and has become constipated. With the biggest cause of bed wetting being constipation (the poop in the rectum squishes the bladder overnight and makes it hiccup), she has been bed wetting more frequently.
At home, her Mum prompts her to sit on the loo to try and poop after dinner if she hasn’t during the day, and often she does manage to poo. Her Parents also prompt her to do a wee before bed, even if she doesn’t think she needs to, and she usually does one. Without these prompts she pooped less and also often skipped her last wee before bed.
Other changes while staying at her cousins were eating white bread where she usually has brown at home, and her cousins are also allowed to drink fizzy drinks at dinner time. White bread has less fibre than brown bread and can be constipating, and fizzy drinks can irritate the bladder wall and contribute to bed wetting!
When I looked eat her tummy with my ultrasound, I could see her rectum had stretched a little from being constipated and could feel some hard poop in her descending colon. They are going to get back to monitoring her water intake (concentrated urine can also contribute to bed wetting as it irritates the bladder wall) and prompt her to sit on the loo after breakfast and dinner to try and poop and she is going to resume her stool softener (lacson). She is also going to monitor and increase her fruit and veg intake as she has been eating more coco pops and chips recently!
I have asked her Mum to keep me updated via WhatsApp, but I doubt I will need to see them again.