Science-y article ahead... readers, ye be warned!

"Don't drink toomuch before bed..."

"Did you go to the bathroom? Well, try again..."

"You should go to that sleep-over. You can go in the bathroom to put on your pull-up, your friends won't know."

For many parents, these are everyday conversations in their house... with their 10 year old (or older) child. According to Up-To-Date, a resource that gives current, evidence-based practice treatment guidelines, bed-wetting occurs in 16% of 5 year olds, and 1-2% of children will still be wetting the bed at age 15!

Bottom line, if your child is under the age of 6, mainstream medicine has no concern about bedwetting. It is common enough, even through middle school, that many providers reassure parents that it can still be normal.

But is it?

Bed-wetting, or nocturnal enuresis, has happened through recorded history, earliestreports in 1550 BC. Various methods have been used to "cure" the person of this problem--from boiled mice to electric shocktherapy. You can see more about the old and recent treatments here. Aren't you glad we no longer use most of these methods?

An article by Michael Salmon, published in 1975, walks us through the reasoning, knowledge, and treatments used in various places in history. If one reads closely, you will notice that there are two main areas of discussion. The first is the debate between laziness and pathology--meaning is the child 1) doing this to be defiant, or 2) is there an underlyingproblem that is causing this? The second area of discussion is the link between mental and physical health, and bed-wetting. In 1870, a link between incontinence and epilepsy was suggested. In the late 1800's, two separate articles found a probablelink that children who struggled with late bed-wetting had a higher risk of developing a form of "insanity" (mental health issues, severe depression or anxiety, OCD, schizophrenia, etc.) later on.

Adams addresses laziness versus physical condition in 1844, saying:

None of the brute creation will lie in their urine if they are not tied or penned; then why do we attribute this practice in the rational being to mere laziness? Simply because some physicians are not able, by a careless or superficial examination, to find the cause, and well knowing that their reputations will be at stake if they do not account for the act, they too often condemn the helpless child to daily floggings.

So if there is a cause to this, what's the link?

According to Dr. Natasha Campbell-McBride, the link is unhealthy gut flora. This is consistent with the link suggested of bed-wetting to mental illness, epilepsy and insanity. When the gut flora is abnormal, the flora of the entire body becomes abnormal--including the groin and bladder flora. In bed-wetting, cystitis, frequent UTIs, urge incontinence, and other similar conditions, the root of the problem appears to be the same. Healthy flora makes the pH of the bladder low, keeping pathogens from adhering to the gut wall. Unhealthy flora allows an overgrowth or bad flora, leading to urinary tract infections. The leaky, damagedgut allows a build up of irritating toxins, which often accumulate in the bladder. As the toxicity in the bladder increases, the bladder is stimulated to empty. While awake the person will usually be able to answer the sudden urge, but when in deep sleep the bladder dumps the toxic urine, whether the person awakens or not. So she suggests that the cause of mental illness is not bed-wetting, but rather, both are caused by abnormal gut flora (Gut and Psychology Syndrome, 2011, p. 102-103).

If this is true, then there is a hope of curing bed-wetting, cystitis--and preventing or treating many other possible illnesses that are worse.And it is for this reason it is so important to address the root of this and other health problems. Putting a band-aid on it will not make it better, or make it go away. To enact lasting change we must fix the problem.

Congratulations! You made it through this technical article! I hope you learned some helpful things! I am so excited each time I learn another symptom or problem that will be helped from addressing unhealthy gut flora!

And we learn, and continue...

Onward!

References:

Campbell-McBride, Natasha. (2011). GAPS Practitioner Training Manual. Medinform Publishing, Soham, Cambridge.
Salmon, Michael, A. (1975, July). An Historical Account of Nocturnal Enuresis and its Treatment. Section of the History of Medicine, 68, pp 443-445.
http://www.uptodate.com/contents/bedwetting-in-children-beyond-the-basics