Enuresis and Pee Accidents: Understand Why They Happen And How To Treat Them
Pee accidents are frustrating for you and your child. You’re both left wondering what’s wrong and how to keep it from happening.
At The Constipation Gurus, we’ve learned that there isn’t one universal reason for kids to have accidents. There are a lot of things that can contribute to a child having bowel/bladder accidents.
That’s why we’ve put together this article to help you learn more about pee accidents, what causes them, and how to make pee accidents and bedwetting a thing of the past.
What Is Enuresis?
Enuresis is involuntary urination. It can happen during the day and show up as damp or wet underwear or at night as bedwetting.
One of the words in the definition that often gets overlooked is “involuntary.” No one – especially a child with enuresis or bedwetting – wants to voluntarily wet themselves.
For the sake of simplicity, we’re going to use “pee accidents” to cover all the different types of enuresis in this article.
Causes of Pee Accidents
There are many reasons that can explain why a child has pee accidents. Some children have one cause of pee accidents, while others have multiple. The key is to understand and address the cause(s) behind it.
Let’s dive into some of the most common reasons we see with our clients for pee accidents.
Not Getting REM Sleep
If your child snores or breathes through their mouth at night it may indicate that they’re not getting into the REM sleep stage.
Why does this matter when it comes to bedwetting?
During REM sleep, the body produces antidiuretic hormone (ADH). ADH is produced by the kidneys and keeps us from wetting our beds. If your child isn’t reaching REM sleep then that hormone isn’t getting produced, leading them to wet their bed.
There are several reasons why your child may not be getting enough REM sleep that should be discussed with your child’s pediatrician.
Constipation
When your child is constipated, and their rectum and bowels are full of stool, it can press on the bladder not allowing it to fill to its full capacity. This pressure on the bladder from the full rectum can result in pee accidents.
Overactive Bladder
Maybe your child has a sudden, strong urge to pee, but it comes on so quickly that they can’t make it to the bathroom in time. This might be because they have an overactive bladder.
An overactive bladder is an involuntary contraction of the detrusor muscle of the bladder. The detrusor muscle is the name for the muscle that surrounds the bladder and contracts to empty the bladder.
We also see an overactive bladder happening along with constipation in children.
Giggle Incontinence
When you – or your child – giggle or laugh, it causes an increase in abdominal pressure. This increase in pressure can cause an involuntary loss of urine, resulting in a pee accident. Giggle incontinence can also be due to weak pelvic floor muscles.
Stress Incontinence
Like giggle incontinence, stress incontinence happens when there’s an increase in abdominal pressure. But rather than being caused by giggling, it can occur with coughing, sneezing, lifting heavy weights or objects, running, etc. Many women may also experience this after giving birth.
We see this happen frequently in kids due to weak pelvic floor muscles.
Underactive Bladder
This happens when a child holds in their urine and ignores the urge to go. This child may only urinate 2-3 x day leading to a large amount of urine in their bladder after they void which then leads to leaks.
Urinary Tract Infection
A urinary tract infection can lead to leaking and accidents. Since your child may not have had this before, they may not have the words to describe what they’re feeling and what’s happening. If you see blood in their urine, it’s time to visit their pediatrician.
Not Drinking Enough Water
While it seems counterintuitive, not drinking enough water is a common reason for pee accidents. Many parents reduce their child’s fluid intake in order to limit accidents. However, in our practice, we see that this can actually worsen accidents.
Not drinking enough water can increase urine concentration which irritates the bladder. This irritation triggers the bladder to contract and leads to urine leakage.
Ideally, your child should be urinating every two to three hours.
Neurogenic Causes
Conditions such as spina bifida or cerebral palsy affect the spinal cord and can also involve the nerves that control bowel and bladder function. Therefore, children with spina bifida or cerebral palsy may have more difficulty or issues with their bowels and bladder.
Poor Toilet Training
If your child struggled with toilet training, they may be at risk for pee accidents. This occurs often with those children trained too early before they were emotionally and physically ready.
When this happens, the child may have never learned how to properly coordinate their pelvic floor muscles. Pee accidents are common if your child doesn’t know when or how to contract and relax their pelvic floor muscles.
ADHD
Children who have ADHD have a higher rate of pee accidents than children without ADHD. We don’t understand why. We suspect that they focus on other things and ignore their body’s signals when they need to go to the bathroom.
Medications
There are a number of medications that may cause enuresis and bladder problems. If the accidents started after starting a new medication, we recommend talking with your child’s pediatrician about the medication. Check with them to see if it could be contributing to the accidents.
Genetics
There is some research showing that if one or both parents had nighttime bedwetting, then their child may have it as well. If that is the case, then don’t lose hope. The child’s bedwetting should stop around the same age that the parent outgrew it.
Pee Accidents and Enuresis Treatment
With the variety of reasons for pee accidents (we know that was a long list), you’re probably wondering how you treat it.
When a new client comes to us with pee accidents we start by talking with the parent and child. and try to uncover the underlying reason for the accidents.
Pelvic floor weakness or dysfunction can be the underlying cause of urinary leakage. This is often addressed by doing pelvic floor strengthening exercises and using biofeedback so that the child can learn and understand what it feels like to contract and relax their pelvic floor muscles.
Most kids actually enjoy pelvic floor therapy because we incorporate the exercises into play and games. We’ve seen great results with pelvic floor therapy.
If constipation is the underlying problem, we start with a cleanout and address constipation with an ongoing bowel management regime.
For those kids who don’t recognize their body’s signals when they need to pee we work together to help them recognize and respond to those signals.
We work with every client on hydration and nutrition recommendations for great bowel and bladder habits, too.
We know that when your child has accidents, it’s easy to get angry, confused, and frustrated. That’s why we’re here to help.
Looking For Help?
After years of working with children who have enuresis and bedwetting and their parents – we’ve developed the Constipation Solution Package. Even though this package is called the “Constipation Solution Package,” we also work with clients dealing with pee accidents.
When you purchase this package, you go from not knowing how to help your child to – being empowered and having an actionable plan. You’re confident that you and your child can implement this plan to put pee accidents and enuresis behind you. Once and for all.
Since every child is different, we’ll work with you and your child to uncover the underlying reason(s) for their accidents and develop a personalized plan. You’ll start with a 45-minute session with Jessica, our dietitian, and Annette, our pediatric pelvic floor specialist.
In this session, we’ll get to know you and your child and understand the issues your child is having, and the underlying reasons. Together, we’ll develop a plan to start recovery.
You also get to choose whether to have one or two 30-minute follow-up sessions. This is where you can check in and get more support for you and your child.
When you purchase the Constipation Solution Package, you also get our Poop Boot Camp. Poop Boot Camp provides information on constipation and withholding and how to treat them.
As a part of Poop Boot Camp, you’ll become a member of our private Facebook group with other parents dealing with the same issues as you and your child. It’s a safe place to talk about what’s going on with others who get it.
Working with us means that pee accidents will become a thing of the past.
Once you purchase the package and the number of follow-ups you want, you’re sent to a scheduling page. There you can make your first appointment. Easy peasy!
If you’ve already purchased our Poop Boot Camp, you get a credit toward the package price. Just email us, and we’ll send you the code to use when checking out.
