Bedwetting (Enuresis) (Nocturnal enuresis)

Continuing to wet the bed past a certain age is a common and heart-wrenching problem for all concerned but it can be seen that, so long as a holistic approach is used that takes into account what is causing the problem, it can definitely be cured...

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Finding a good herbalist

Most of what's written in this article is entirely suitable for a person to work through themselves but, especially if things are quite bad, or you just know that you need further help, then there may be a great deal of benefit to you to go to whatever lengths necessary to find a good herbalist or truly holistic practitioner to guide you on to a safe and strong treatment program. There's a short write-up to suggest how you might go about finding such a person here

Be careful what you call it

There are many theories about the psychological aspects of this issue and there is value in keeping an open mind about all that but there is one thing that is patently obvious and that is that this problem is always made worsened by the anxiety it creates in the child. The older they get the worse they feel about it and it is clear that being ashamed of it does not help them stop doing it when they are asleep! In fact it probably really just makes it worse...

Because of this I recommend starting out by finding ways to ease some of the tension around the subject and simply changing the language is an easy and practical place to begin. When parents come to see me with a child who is wetting the bed the first thing I typically do in my practice is to ask everyone to drop the term 'bedwetting' and instead use the medical term enuresis (the full description is nocturnal enuresis) but enuresis is easy enough to remember.

You may be surprised at what a difference this simple step creates. It helps the child and their parents get out of a stuck and unhelpful place of 'this is all my fault' and into a mind-set of 'this is a problem and we are working towards a solution'.

Primary causes of enuresis

These are the primary causes of enuresis along with some suggest, practical solutions:

Natural Development

There are some very practical questions to enuresis that can tell us if this is the area that needs closer scrutiny;

a) does he or she have a good level of control of the muscles we use when we go to the toilet and when we need to hold on?

A practical way to test this is to try to stop the flow of urine once it has started but before it has finished. Most children won't be able to do this at first but can learn to at least try with some practice. If this is clearly a weakness then simply practicing trying to stop the flow of urine before it's finished, even just once a day, can make a rapid improvement over as little as a week, especially if this is the core issue or one of the main causes of the enuresis.

b) for boys: is his foreskin too tight?

You may need to help a little boy to retract his foreskin to urinate a few times until he gets the hang of doing this himself and can then easily empty his bladder fully.

c) is he or she getting a good balance of water in and urine out during the day or is it quite erratic?

Keeping a chart of exactly how much fluid is being drunk and when it is being drunk for a few days might give a lot of insight as to why his or her natural rhythms may not be getting properly established. By way of example of this last point the following is copied from an online discussion with a local colleague

"My son was a late bed wetter, well into his teens. We had some success with an alarm but didn't completely get on top of it.

What sorted it in the end was an appointment with Nurse Maude (a Canterbury nursing service), who have a nurse who specialises in dealing with children and teenagers with incontinence issues. She was brilliant, she made him feel okay about it and not alone, and by getting him to fill in a timetable of when he was drinking and urinating for a week or two, she soon sorted the fact that my son's drinking and thus urinating pattern was all awry.

The program he had to follow consisted of set volumes to drink at set times of the day to change when he was drinking and increase bladder volume and control and it worked a treat - very quickly too"


Food Intolerance.

I and others have sometimes seen a correlation between children with enuresis and a tendency towards food allergies or intolerances. How the one could cause the other can only be speculated on but perhaps the general aggravation of the immune system that happens with food intolerance causes some degree of inflammation in urinary tract tissues just as it can in the skin (e.g. eczema) or the bronchial tubes (e.g. asthma).
Or, just as we know how food intolerances can trigger significant behavioural changes in children and adults perhaps they can also cause a more sensitive nervous system response to bladder stimulation as well...

Because it is such a tricky area, before zeroing in on this I would look for other indicators of intolerance, such as the common childhood illnesses of eczema or asthma as just mentioned, or other physical signs such as dark rings under the eyes (allergic shiners) or cracks in the corners of the mouth.

Sometimes parents have a hunch that certain foods are making the problem worse but just can't pin it down much further. As described in the detailed article linked just below, it is vital to systematically work through the tricky issue of diagnosis. If this important subject needs to be explored further, then read here.


Chronic Infection

For many decades, the medical establishment's view on chronic infection was very black or white; you either had an infection or you didn't. In recent years, there has been an explosion of understanding into the reality that all of us have many billions of organisms living on us and inside us and that the right balance and numbers of these bugs are an essential part of our health for better or worse.

Does he or she have trouble holding on to their urine during the day and needs to go to the toilet quite a bit more frequently than other children their age? If so then consider the possibility that they may have a low-grade bladder infection that is causing just enough inflammation and irritation to trigger the enuresis when the child falls deeply asleep.

It may be helpful to do some urine tests to see if there are small numbers of white blood cells (leucocytes) in the urine. This may be passed off as normal because they are not at the very high levels that come with an acute bladder infection but they may also be the sign that there is a chronic and low grade infection pushing things along.

In such an instance, there are certain herbs that are of much help in this area; especially: Uva Ursi, Corn Silk, Raspberry leaves, Marshmallow root and Shepherd’s purse. The advice written up in the article on urinary tract infections gives a broader view of this subject, found here.

Sometimes we can't be certain about ruling out a chronic infection and so have just proceeded with a treatment of the UT tea as described in the above linked article. This tea has been seen to be extremely effective at helping with bladder infections so if person gets better you can know you were on the right track but if nothing happens after one or two weeks then it's fairly safe to assume this is not a core issue.

Arctostaphylos uva-ursi (Bearberry)


Nerve impingement

Nerve impingement can be a major factor for some children with chronic enuresis. Perhaps the only way to be able to know for sure about this is to visit with a practitioner who is skilled in analysing and adjusting the spine and see what happens if they find that there is a problem in the alignment of the pelvis or the low back and help to correct it. As hard as this may be to believe if you haven't witnessed it, one or two simple adjustments can sometimes hold the cure in such cases!

Speaking from some further experience in this area, if you find that you visit with a chiropractor, osteopath or some other spinal therapist and that your child improves after treatment but then reverts back to the enuresis after a while then this means that you are not on the wrong track (or they would not have improved in the first place) but that you need to find some exercises that the child can do to prevent the spine getting out of alignment and the nerves getting pressed on again. This is usually to do with correcting some postural imbalance in sitting, standing or walking.

A holistic minded spinal specialist should be well and truly able to teach your child such exercises but if if it is not their forte then you might find visiting someone who works in the Yoga school, or the Alexander technique, or perhaps the Feldenkrais method to get the tools he or she needs to learn to get well and stay well in this regard.


Further Strategies

~ It makes sense to at least try the strategy of waking him up to go to the toilet after he has been asleep for a couple of hours.

~ Surely it is wise to make sure he or she has very little extra fluids for an hour before going to bed.

~ Bed 'under-blankets' that sound an alarm when they get wet presumably must work for some but do not seem to be all that well rated by the people I meet who have tried them, but then they wouldn't come to me if they had worked so I just can't say how useful it may be for others to spend time and money on this avenue. If you are local and haven't explored this option then it might help to see for a NZ developed alarm and a reputedly very pleasant to deal with company, note that I have zero financial interest in this business.


Final Thoughts

Be patient:

Enuresis is a truly depressing problem for everyone concerned. Whatever you do to fix it you are going to want it to work brilliantly, and immediately! This is completely understandable but it is also the number one reason why treatments fail because even when you are on the right track and the incidence of enuresis has been reducing, just one accident can be enough to cause people to lose hope much too soon and so stop what they have been doing. Don't give up too quickly, a cure for a chronic problem will often take time.

Be holistic:

Another suggestion is that it may be wise to try more than one of the above approaches at the same time. In my practice, I am always combining different treatments and none of us seem to be bothered when we don't know what helped the most so long as the problem is cured...

Whatever you do, remember that this is never a problem that should be put in the too hard basket. Every child who has not been born with a bad physical disability will eventually grow out of their enuresis but, if you adopt a holistic mind-set to treating it as a real problem, then it is certain that you will bring that day a great deal closer.

Zea mays (Corn silk)

Please understand that I cannot personally advise you without seeing you in my clinic.
This living 'book' is my labour of love so, wherever you are, I wish you peace & good health!



© 2011 R.J.Whelan Ltd