Bed wetting constipation dramas

[Queenofthedrivensnow]

Dd2 started bed wetting about 18 months ago. She is just 6 so definitely secondary enuresis. In July this year we were prescribed Movicol as she had no regular poo routine and some constipation. By September she was wetting most night and I put her back in pull ups. We made some progress but mostly because I lift her before I go to bed. Exh won't co operate so she won't wear pull ups anymore.

School nurse referred to continence clinic they prescribed sodium picosulphate which we started on 28th. 1ml. Hasn't worked instantly as promised. Took until 4am this morning for dd to poo and she had already wet the bed last night and was really upset about it. Dd woke to poo no problem but my god the smell!!!!! Is this normal?

Feel like I'm failing to get this sorted and she was so upset last night

Anyone?

Has she been checked for infections? Been referred by your GP to a specialist?

1ml is a very low dose. Ds is on 10ml most days with 5ml as maintainance.

If she hadn’t been since the 28th then yes it will smell! I would bet back onto the contience nurse on Monday

Referred to continence clinic they changed treatment from 2 sachets laxido down to 1 plus the SP. not checked for infections just tummy exam and big assessment

It sounds like she might need a clearout to get rid of the backlog

@Sirzy several tummy exams have said she might have a little but being held back but not a huge amount.

She is scoring 4 on the Boston poo chart but prior to starting the SP every poo was v messy and sticky and causing soiling. Continence nurse didn't have a clear answer about this just wanted to try the SP and see if it helps. To be fair after another 3 days with no poo we had the first non sticky gross poo in a year!!

Above advice to do a full clearout with Movicol / laxido is a good place to start. Increasing doses until poo is brown water. Tummy exams not always reliable - there could be a lot of poo inside. Then drop down to a maintenance dose + the pico to keep her clear.

Other avenues to explore. Is your daughter drinking enough during the day? Bladder is a muscle which needs filling and emptying several times a day to keep it working properly. If your daughter is worried about the bedwetting she might be drinking less thinking that will help - but it’s counterproductive.

Aldo worth considering, if it’s not constipation, is there something worrying her? Stress can interfere with the way the body regulates the production of vasopressin, the hormone that controls and reduces the production of wee at night.

@Thesunrising it's so complex isn't it. Gp referred her to Camhs but they didn't accept it. I knew they wouldn't.

We have the 1400ml a day rule but this is also a challenge.

I have gone back to waking her for a wee because she got so distressed about wetting.

I don't think she restricts fluid she often complains she is thirsty and I never take her anywhere without a drink.

Find it very confusing as dd1 (9) has been dry at night since potty training and has a normal poo daily. They eat exactly the same and she never has any issues and thinks it's bizarre that dd2 does.

It is indeed a hard one to get to the bottom of @queenofthedrivensnow Has the GP suggested Desmopressin - a synthetic replacement medicine for the vasopressin hormone. Or have UTIs been ruled out? If your daughter was a bit older then a bedwetting alarm treatment might be considered, but at 6 it’s maybe a bit too young to consider that. Without wishing to alarm you, bedwetting that starts after a child has been dry at night can also be a sign of T1 diabetes - but this is very uncommon.

Last thought is about what she is drinking. Dark drinks (like black currant squash), orange juice and caffeinated drinks can aggravate the bladder, so if she is drinking any of these might be worth trying to cut them out?

@Thesunrising your post is really helpful. We were advised by school nurse to cut out black currant or berry type drinks but also told this was anecdotal evidence. Continence nurse batted it away but we stick to orange only. She won't drink water on it's own and we were told not to count milk as a fluid.

I was hoping for the bed alarm not more drugs at next review.