Enuresis/encopresis - could do with some MN help :)

[iwouldgoouttonight]

I've posted on here several times about DS (8) wetting and soiling daily and I've had some brilliant advice which has really helped (more than the doctors have tbh).

We've now got to the stage where he's on 20ml senna each evening, 3 scoops of Optifibre a day and one sachet of Movicol each day, and that seems to have (fingers crossed) really helped his poos. He is no longer impacted/constipated, and he poos every morning. In the last two months he's only has three soiling accidents. Six months ago I couldn't ever have imagined writing that.

But I wonder if anyone has any experience of what happens with wees once the bowel is sorted. We were told that as the bowel was so full of poo it would have stretched and given very little room for the bladder, which was what was causing the wee accidents. Now the bowel is empty but the wee accidents have got a lot worse.

We weren't expecting an overnight improvement, but hoped that as the bowel gradually shrinks back to its normal size, and the bladder can gradually fill to the size it had supposed to, then the wee accidents would gradually decrease. He's always done two or three small wee accidents throughout the day, some just a dribble and some enough to show through his trousers. But now he's doing several big full wees every day, enough to soak through his trousers, and whatever he's sitting on.

Does anyone have any idea why he might be doing more wee accidents? He's been tested to rule out a UTI. We've measured how much wee he does in the toilet and its only around 50ml each time - I understand it should be about 300mls (age8+2 x 30 = 300ml). He's drinking nearly 2 litres of liquid a day, which was recommended to fill his bladder.

[iwouldgoouttonight]

Bumping for the evening crowd.

[DoItTooJulia]

No idea, but hate seeing posts like this unanswered.

2 litres is a lot of water for a little one with bladder control issues. Maybe cut that down just a touch? And what about those panty liner type things f r kids. Should hold a dribble and hopefully alert him to his need to go?

Feel free to ignore, I have no medical background or experience of these issues!

Hope it goes well for you both!

[handmadewithlove]

It will take a lot longer than you think for everything to get back to normal. Is it day or night or both?

[iwouldgoouttonight]

It's day and night. We're not even thinking about nighttime yet, we just want to get daytime sorted.

I think 2 litres sounds a lot too, it seems counterintuitive, but the doctors have said he needs to drink loads to increase his bladder capacity.

[handmadewithlove]

Are you under gp or consultant at the moment? Part of the problem can be that the sensation of needing to wee can be 'lost' as the brain doesn't understand it. Lots of fluid helps with both stretching the bladder and getting them used to the sensation of needing a wee. Does he have any control eg does he start to wee then manage to get to the toilet, or does he just flood?

[MadauntofA]

It may have gone on so long that his bladder needs a bit of help to adjust. It sounds like he is drinking a bit much. You can do bladder exercises - trying to get him to hold on for short periods of time when he says he needs a wee. He might need some medication to relax the bladder. The ERIC website is good. Go back to your clinic and ask about help for the wetting as it is miserable for your poor DS

[iwouldgoouttonight]

Thank you. Yes he's under a consultant and a urology nurse. Our next appt isn't for three months so I was just looking for advice beforehand.

I think you're right that the sensation of needing to go might be lost, although he can go sometimes, and sometimes starts a wee and runs to the toilet in time. The doctor did suggest trying to get him to hold onto his wee for a short while after the feeling of needing to go, to try to strengthen/stretch the bladder, but I don't think he's even able to do that yet. When he needs to go he needs to go now!

He's taken Tolterodine before but it didn't have any effect, but that was before his bowel was clear. Maybe he needs to try that again. We'll ask at the next appt.