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My 5-year-old wets his bed
Q: My 5-year-old son wets the bed at night. We’ve tried restricting his fluids in the evening and waking him up to pee in the middle of the night, but these haven’t really worked. Somebody mentioned to me that bedwetting might be related to constipation. Is this true? How do I know whether my son is constipated since he goes to the bathroom on his own?
A: Fahim, bedwetting is very common. Approximately one in seven 5-year-olds wet the bed at night. For most children who wet the bed, it just takes a little longer for the natural control of their bladder to develop. You’ve already done some things that can help: limiting fluids in the evenings and waking your son to urinate. Rarely, a medical problem such as a urinary infection can cause the bedwetting, so be sure to discuss the problem with your son’s doctor. The doctor will examine your son and may do some tests. She may suggest a bedwetting alarm or certain medications.

You are right about the connection between constipation and bedwetting. Studies have found that children who wet the bed are more likely to be constipated, and children who are constipated are more likely to wet the bed. Since a child’s rectum and bladder are very close to each other, a rectum that is full of stool from constipation can push on the bladder and the surrounding nerves and muscles. This can send confusing signals to the bladder and brain, which can interfere with bladder control and lead to bedwetting.

How do you know whether your son is constipated? Children are constipated when they have large, hard stools that are difficult to pass. You son might complain of stomach pain or pain in his bottom when he has a bowel movement. Constipation can also sometimes lead to leakage of stool, and you might notice stains in his underwear. Also, you can check his bowel movements for a week. Explain to him that the doctor suggested you check his poop, and ask him not to flush and to let you know after he has pooped so you can check it out. Some children have a bowel movement every day and others every few days. The most important thing to note is how hard or soft his stool is. If his stool is well-formed but soft, like the consistency of peanut butter, it would be considered normal. However, if his stool is hard like pebbles, and especially if you see streaks of blood on them, it would mean that he’s constipated.

To reduce the chance that constipation is contributing to your son’s bedwetting, make sure he eats a diet to soften his stools. Increase the amount of fiber in his diet by giving him whole-grain cereals (oatmeal, whole-grain bread and crackers) and plenty of vegetables and fruits. Also be sure he drinks plenty of liquids during the day. Water is good, and a cup of apple or prune juice can help, too. Also talk with your son’s doctor about the constipation. She may recommend a stool softener or laxative as well.