Associate Isabel Harper from Clarke Willmott’s serious injury and medical negligence team specialises in helping clients who are seeking a compensation claim for bowel incontinence following childbirth, personal injury or because of medical negligence.

Isabel explains the rehabilitation process after a bladder or bowel injury and why you may wish to seek legal advice.

Who is affected by bladder and bowel problems?

Bladder and bowel problems can affect anyone at any stage of life, but sometimes they can happen unexpectedly because of an accident or following medical treatment.

At Clarke Willmott, we have found that the types of treatment that lead to these types of injuries include, general surgery, bowel cancer, spinal tumour, infection / sepsis, prostate problems, stroke, and neurological conditions. Women are also often effected by bowel and bladder injuries following childbirth.

Some people may have also been injured as a result of a road traffic accident, or an accident at work, for example.

Where can you get help if you have bladder and bowel problems?

If an injury has occurred suddenly, you may wish to prioritise treatment in addition to rehabilitation in order to manage and minimise your symptoms. It is important that you seek help from a GP or a healthcare professional. You may wish to consider asking for help from the following:

1. Clinical Colorectal or Urology Consultant: They are able to provide you with specific advice on further treatments that may be available to you.
2. Physiotherapists: There are specialist pelvic health physiotherapists who will be able to provide an assessment, treatment, and support for those who struggle with their pelvic floor. They see patients with a range of symptoms. Including those who suffer from pelvic pain, faecal incontinence, and urinary incontinence (including, urgency and frequency) etc. If you are suffering from these symptoms as a result of childbirth, there are physiotherapists who also specialise in women’s health.
3. Pelvic floor clinics: These clinics treat people who have problems with their bladder and bowel, including bowel disfunction, bowel incontinence, irritable bowel syndrome (IBS), constipation, urinary incontinence, bladder pain, urinary tract infections (UTIs) etc. They usually carry out a multi-disciplinary approach. This means that they work closely with a range of health services. For instance, they may work with specialists in the fields of gynaecology, colorectal, urology, physiotherapy, pain medicine.
4. Psychologist / Psychiatrist: Suffering from a bowel or bladder injury is traumatic. It is no surprise that you may be suffering from psychological symptoms as a result. There are a number of therapies and treatment available that can help to alleviate the symptoms that you experience. It is important that you speak to GP or other healthcare professional. This way, they can ensure you are signposted to the right services.

If you are unsure about where to turn, you could contact the Bladder & Bowel UK Helpline on 0161 214 45910. Moreover, the helpline can help to provide advice on bladder and bowel health, continence promotion and options for managing incontinence, products, as well as signposting to services. They offer general information, advice and signposting for bladder and bowel issues. For personal medical advice, we recommend that you speak to your GP.

What products can help you manage your bladder and bowel problems?

As well as the above, there are several products available to help you manage your injuries on a day-to-day basis. In addition, you may wish to consider the products available on the Countrywide Health & Mobility website who are associated with Bladder & Bowel UK, as well as ordering the Just Can’t Wait card from Bladder & Bowel UK.

Why might you need legal advice if you have a bladder & bowel problem?

If you wonder whether your bladder or bowel condition has been caused by a medical mistake, a solicitor can obtain expert reports from experienced clinicians to ascertain what might have gone wrong. If you have been injured in a road traffic accident or accident at work, then a solicitor can investigate the cause of that accident to assess if you have a claim. This is an important first step in bringing a claim as it will be necessary to show someone else has negligently caused your injury.

What will a solicitor do if you have a compensation claim?

As well as looking at how the treatment may have been negligent or how your accident could have been avoided, the Solicitor may also look at ways to minimise the effect of your injury and to minimise the discomfort caused by your bowel and bladder symptoms. They are likely to look at:

• What the impact has been on your employment.
• What your care and assistance needs are.
• If you would benefit from funding any future treatment, therapies, or rehabilitation.

If your solicitor can secure an admission of liability, you may wish to ask them to request an interim payment of damages to fund any treatment, care or rehabilitation that you may need.

Speak to an expert solicitor

Clarke Willmott have a significant amount of experience in acting for those who have suffered from a bowel or bladder injury, including those who struggle with incontinence / urgency issues, or those with stomas following negligent medical treatment. If you think you might have a compensation claim, you can speak to us by requesting a free call back.

Clarke Willmott is a national law firm with offices in Birmingham, Bristol, Cardiff, London, Manchester, Southampton and Taunton. For more information visit www.clarkewillmott.com.

Clarke Willmott is a member of our legal panel. The Bladder & Bowel UK Legal Panel is a group of clinical negligence and injury specialists with expert knowledge of bladder and bowel care.

This article was written by medical negligence solicitors, Clarke Willmott.

The post Guide to rehabilitation after a bladder or bowel injury appeared first on Bladder & Bowel UK.

• Am I the only person who has a bladder or bowel issue?
• Who can I speak to about my bladder or bowel problem?
• Do children and young people experience bladder or bowel problems?
• Are continence products the only answer?
• Where can I get reliable help or advice?

At Bladder & Bowel UK we are contacted by people of different ages and stages of life with a wide range of questions and concerns regarding bladder and bowel difficulties. While our team of specialist nurses and product co-ordinator are happy to respond to individual enquiries, we felt it might be helpful to address some of the more common questions we are asked. 

So who is affected with bladder and/or bowel problems?

Bladder and bowel problems are very common and can affect anyone at any stage of life. Many people find it difficult to discuss their symptoms with anyone, including their healthcare professional. However it is important to know that much can be done to treat, manage and improve issues and it is important not to just put up with symptoms, as help is available.

Your GP, practice nurse or other healthcare professional will be used to having conversations about issues that you might find difficult and should respond to you sensitively and with practical suggestions. They will also be able to refer you to the right specialist service, if they feel this is needed.

What about children?

Many children and young people are affected by bladder and bowel issues. These do not always just get better with time. The most frequently occurring problems are difficulties with toilet training, wetting in the day or at night, constipation and/or soiling.

Sometimes it is assumed that wetting, soiling, or rushing to the toilet is due to naughtiness, laziness or an inevitable part of a disability. However this is very rarely the case. Therefore, all children and young people with a bladder/bowel problem, including those who have additional needs, should be offered an assessment, support, and appropriate treatment as the issues often do not simply get better as children get older.

Bladder & Bowel UK Top tips

Seek professional help if you have symptoms.

We would always encourage people to seek professional advice and help about any bladder and/or bowel problems. Much can be done that may cure or improve the issues. Your healthcare professional should be able to offer an assessment or refer you to a specialist service. This will then help indicate the underlying cause and the most appropriate treatment or management options.

Is it to do with my age?

Bladder problems can affect children, young people, men and women of any age. It is not an inevitable part of being young, getting older or having a disability or medical condition. Therefore, please do not put up with bladder and bowel incontinence or difficulties emptying your bladder or bowel.

How do I access help?

You could talk to your GP or other healthcare practitioner, eg. practice nurse, district nurse. For children you could also contact their school nurse or health visitor. If necessary they will refer you onto the right service to offer the right support.

There are specialist bladder and bowel services for adults in most places in the UK and many areas also have specialist services for children. You may need to be referred by your healthcare professional, although some may accept self-referrals.

Alternatively, complete the Bladder & Bowel UK webform (https://www.bbuk.org.uk/enquiries/) and we may be able to offer some initial advice and will help you get in touch with a professional, who will understand and be able to offer assessment and management.

What help can these services offer me?

Bladder and bowel services offer specialist advice, assessment, treatment, management and support to adults or children and young people experiencing bladder and bowel problems. 

Examples of the types of problems that bladder and bowel services may help with include  

• Urinary incontinence (leaking urine) or difficulty emptying the bladder.
• Waking up more than a couple of times in the night to pass urine or wetting the bed during sleep.
• Needing to go to the toilet more frequently or urgently than is usual.
• Pelvic floor disorders.
• Prostate problems.
• Toilet training issues.
• Constipation.
• Faecal incontinence (soiling) or difficulty controlling bowel movements.
• Difficulty emptying or fully emptying the bowel.
• Difficulty getting to the toilet due to disability or another health condition.

Where will I be seen?

Bladder and bowel services usually offer clinic appointments across their NHS areas. Home visits may be arranged for people who are housebound. Your doctor or health care professional will be able to put you in contact with your local service. You can also contact Bladder & Bowel UK for information about how to access your local service.  

What will happen when I am seen?

You will be offered an assessment, to help your professional understand the bladder and/or bowel problem. You may be asked to fill in bladder and or bowel diaries before the assessment, as they will help to identify what is happening. In some cases further tests may be required. The outcome of the assessment will explained to you and the healthcare professional will then discuss the options for treatment or management with you. 

What options are there if I am not able to be fully continent?

Many continence problems are treatable, or can at least be improved. However, it is not always possible to fully treat or cure incontinence. Therefore, it may be that following a full assessment from a specialist healthcare professional, it is agreed that alternative solutions for managing incontinence are the best option in the circumstances. 

A wide range of products, devices and appliances is available. No single one will suit everyone’s needs and it is not uncommon for people to use a combination of products eg. containment pads along with aids to assist with toileting. 

Examples of the types of products available include:

• Bedding and chair protection.
• Bowel irrigation devices.
• Bowel/faecal leakage management devices.
• Catheters, which may be used with drainage bags.
• Urinary sheaths and body worn appliances for boys and men.
• Pelvic floor equipment.
• Swimwear.
• Toilets and Commodes.
• Urinals (male and female).
• Disposable and washable pads and pants.

It is important to remember that there are a number of options that may help cure or at least improve bladder and bowel symptoms. Therefore Bladder & Bowel UK would always recommend discussing any issues with your healthcare professional (GP, practice nurse, or health visitor or school nurse for children).   

Bladder & Bowel UK may be able to provide initial help, advice, support and information as well as signposting to services and other organisations.

We can be contacted via our web form at https://www.bbuk.org.uk/enquiries/

Find more Bladder & Bowel UK resources here: Information library for adults – Bladder & Bowel UK (bbuk.org.uk)

The post Common Questions and Concerns regarding Bladder and Bowel Health Issues appeared first on Bladder & Bowel UK.

General suggestions:

Contact the travel company, airline, coach or train operator to discuss your individual needs before booking and travelling. If luggage or body searches are worry as exposure of your continence products is a possibility there might be a private area where this can be done.

Think about what you need to carry with you, such as medicines and spare products. You may need to have a letter from your doctor to be allowed to carry them through security. 

You may want to ask the operator if you can board early, to ensure you have time to get settled with anything you may need during the journey.

Disposable continence pads:

• Disposable pads can take up a lot of space. Consider taking pads that are more absorbent than the ones you usually use, so that you need to take fewer of them. Or you could try smaller pads that take up less space.
• Make sure you get the products you’re going to need well ahead of your travel date.
• A vacuum pack bag can help to reduce the amount of space pads take up in your luggage.
• Consider using other products eg. men could consider using a sheath instead. 
• Would you be able to manage washable products while away? These take up less space.
• Ask your product provider whether they are able to deliver direct to your holiday destination, or send a supply beforehand. But make sure you have a backup your luggage just in case there is a problem and they do not arrive.
• Make sure you have some spare products in your hand luggage in case your main luggage is lost or delayed. You could also divide your pads between your luggage and that of a travelling companion if you’re happy to do so.
• Contact the travel provider to see if there are any luggage restrictions or if continence products are exempt.
• If you are worried about leakage, consider having a chair protector for the journey.
• Consider the climate you are travelling too. Dampness can affect the absorbency of pads and heat can affect the adhesive tapes, for example on sheaths.
• Remember you will have less to bring home with you, as most of the pads will have been used.

Managing Catheters on long journeys:

• Consider having a urinal, such as a uribag, to empty catheter bags into. A travelling companion can then take it to the toilet to empty this for you.
• Make sure that you carry spare catheters, bags and any other equipment you may need with you.
• Ensure you have some spares, in case of delays or cancellations.
• Divide your catheters and supplies between your hand and hold luggage and consider giving some to a travelling companion, in case of luggage delay or loss.
• Have hand sanitizer and wet wipes in case access to a sink and soap is limited.
• You can get a medical validation or travel certificate from your catheter provider. It will explain in different languages why you are carrying catheters and also has a section urging officials to be discrete.
• Consider using ready-to-use hydrophilic catheters if you are travelling in countries with poor water quality.

Accessing the toilet:

• Try to book a seat near the toilet and on an aisle.
• Consider using a pad inside close fitting underwear, in case you cannot get to the toilet quickly enough.
• Think about taking a small bag with wet wipes and spares with you that is easily accessible throughout the flight.
• Be aware that some people find that they are more likely to leak larger amounts of urine when the plane starts to descend. Consider planning a toilet visit just before then.
• If you’re not sure what the toilet facilities are like at your arrival destination, consider a toilet visit before decent begins.

Clothing:

• Wear clothing that is comfortable and easy to rearrange when accessing the toilet.
• Dark coloured clothing makes leaks less visible.
• Loose fitting clothing is easier to remove. 
• Consider having a spare set of clothing and a plastic bag in your hand luggage in case of leaks.

Fluid intake:

• Make sure that you drink enough. Plenty of water will prevent dehydration, help to protect against urinary tract infections and ensure that urine remains dilute. Concentrated urine can irritate the lining of the bladder and increase wetting.
• Avoid tea, coffee, hot chocolate and alcohol as all of these increase urine production.  
• Avoid fizzy drinks as these can irritate the bladder lining.

Bowel issues:

• Try to stick to your usual diet routines when travelling to avoid feeling bloated, nauseous or uncomfortable. Digestion and body clocks can be upset by crossing time zones.
• Try to move as much as you can, particularly on long flights. This will help with both circulation and digestion.
• Discuss with your health care professional whether an enema or suppository a few hours before the flight would be an appropriate way for you to try and avoid a bowel motion during the flight.

Find more Bladder & Bowel UK resources here: Information library for adults – Bladder & Bowel UK (bbuk.org.uk)

Find NHS advice here: https://www.nhs.uk/conditions/urinary-incontinence/

The post Travelling with a continence problem appeared first on Bladder & Bowel UK.

Other blogs published this week have provided information on lifestyle changes that may help, the treatment that is available, why bedwetting should be treated, the myths and facts surrounding the condition, information for teenagers and adults and tips to help you manage. 

This blog is about the support you can get from your healthcare professional

GP’s, School Nurses and Health Visitors are part of the team of health professionals called universal services. They are your initial support for bedwetting. They should  complete an assessment and provide some advice and  discuss treatment options.

Bedwetting is considered a medical condition from the age of five. It is a common in younger children and while some do get better with time, not all will. Children who are wet most nights are least likely to get better without treatment and, what is less well known, is that bedwetting can continue into adulthood or start again after a time of being dry.

Therefore, you should see your healthcare professional if bedwetting is happening more than two nights a week, if it has started after being dry at night for six months or more, if you are a teenager or adult, or if it is worrying or upsetting.

What does an assessment involve?

You (or your child, if they have bedwetting) may be asked to keep records of wet nights and of bowel actions (poos) for a week or two. The healthcare professional may also want a bladder diary. The bladder diary is a record of which fluids and how much have been drunk over two or three days. You will also need to write down when the toilet is used and how much urine is passed. Most children will need help to keep the bladder diary and it should be done over a weekend, or during school holidays.

The information you keep about wet nights, bowels, drinking and passing urine will allow the health professional to see how well the bowel and bladder are working. There is a bladder diary, with instructions on how to complete it on the Bladder & Bowel UK website – www.bbuk.org.uk/wp-content/uploads/2022/11/Baseline-Bladder-Diary-paediatric-Bladder-Bowel-UK.pdf – or your healthcare professional may provide one.

It is likely that your healthcare professional will ask questions about how long the bedwetting has been happening, about general health, and medical history. For children you may be asked about toilet training. it is important to also tell the health professional about any problems with toileting during the day, including damp, wet or soiled underwear, having to get to the toilet quickly, or going more often than usual: most people need to pass urine (wee) 5-7 times a day.

Your healthcare professional should explain to you what they think might be causing the bedwetting and should be able to suggest ways to help. This may include treatment for constipation if that is present, good drinking and toileting routines, as this can help the bladder to work more effectively. Good routines include having a water-based drink about every two hours, avoiding fizzy and caffeinated drinks (tea, coffee, hot chocolate, cola and many energy drinks contain caffeine) and stopping drinks an hour before bed. They may also suggest medication as this is helpful for some.

Dependent on the bedwetting symptoms and any progress that is made with following advice they give, your health care professional may, after discussion with you, be able to refer to a local specialist bladder and bowel service or bedwetting service for further assessment and support. There are specialist bladder and bowel services for adults throughout the UK and there are specialist children’s services in many areas. Where there is no children’s service, your child may be referred to a paediatrician.

Therefore, this World Bedwetting Week if you, or your child is affected by bedwetting, ask the GP for advice and support. If it is your child that is affected, you could speak to their school nurse or Health Visitor.

Where can I get more help?

You can find more information about bedwetting and other bladder and bowel conditions on the Bladder & Bowel UK website. Information for adults is at www.bbuk.org.uk/adults/adults-resources. Information for children is at www.bbuk.org.uk/children-young-people/resources-for-children. You can contact the Bladder & Bowel UK helpline for free confidential advice – www.bbuk.org.uk/enquiries.

There is also information – www.stopbedwetting.org – and – www.worldbedwettingweek.org.

The post What can I expect from my GP, School Nurse or Health Visitor? appeared first on Bladder & Bowel UK.

Bedwetting is a medical condition. It is not caused by anything you, or your child are doing wrong. It is not the result of laziness or naughtiness. If you are finding it difficult to deal with bedwetting speak to your healthcare professional and ask for advice and support to make it easier to cope.

What can I do to make the bedwetting less likely to happen?

• Encourage your child to drink six to eight cups or glasses of water-based drinks a day, spread evenly throughout the day, from waking up until an hour before bed.
• Avoid letting your child have fizzy drinks, except as an occasional treat.
• Avoid drinks with caffeine in them: tea, coffee, hot chocolate, cola and many energy drinks contain caffeine.
• Avoid your child having anything to drink in the hour before bed.
• Avoid your child having any food in the hour before bed, particularly food that is high in salt or protein.
• Make sure your child goes to the toilet just before they go to sleep.
• Try to stick to a good bedtime routine. Avoid computer games, television and other screens in the hour before bed.
• Try to make sure your child’s bedroom is dark.
• Try to make sure that your child can get to the toilet easily if they wake up during the night: you could try a potty or bucket in their room, leaving a light on in the bathroom, or giving them a torch to have by their bed.

How can I protect the bed?

There are lots of options available for mattress protectors. These are sold online and in shops that sell bedding. Some cover the whole mattress; others are smaller and are usually called bed pads. Bed pads sit on top of the sheet, and some have wings to tuck under the mattress to hold them in place. They are designed to absorb fluids and can be washed in the washing machine.

Disposable bed pads are also an option and can be thrown away when wet. 

Some people chose to use washable or disposable pants or nappies. These are all designed to contain the urine and help keep the bed dry.

How can we manage trips away from home?

Many families worry about sleeping away from home if their child wets the bed. However, there are things you can do to help:

• Take a waterproof mattress cover with you to protect the bed.
• Use washable or disposable bed mats.
• Use disposable pull ups or a nappy while away from home.
• Take extra bedding and pyjamas with you.
• If you are using sleeping bags, you could take a waterproof sleeping bag liner.
• Ask your healthcare professional about a trial of medication (Desmopressin) to help reduce the amount of urine produced at night.  Desmopressin needs to be prescribed and should be tried before the trip away, if possible.

For overnight trips with school or other groups, you could consider:

• Discussing options for discretely managing the wetting with the leader of the group.  They may suggest that your child is woken earlier than the others, to give them a chance to remove any wet clothing and shower in private. They may also be able to make sure that there is a bin in the toilet for disposal of used products.
• Putting a disposable nappy or pants inside your child’s sleeping bag, so that they can pull these on when in their sleeping bag. They can also take them off in the sleeping bag and leave them there, if only away for one night.
• Putting a disposable nappy or pants into a large washbag. When it is time for bed your child can ask to go and do their teeth and put on the nappy or pants in the privacy of the toilet.
• Make sure your child takes a water bottle with them.  If their night clothes are wet, they can pretend they have spilled the drink.

Where can I get more help?

Your healthcare professional should be able to provide some initial advice and support. They will also be able to refer you onto a specialist for treatment, if needed.

Bedwetting is a common medical condition in childhood and can be treated from the age of five years old. However, it can affect people of any age. There is more than one cause for bedwetting and these are outlined in other information on the Bladder and Bowel UK website. For adults information is here – www.bbuk.org.uk/adults/adults-resources. For children it is here – www.bbuk.org.uk/children-young-people/resources-for-children.

The post What can I do to make it easier to cope with bedwetting? appeared first on Bladder & Bowel UK.

Nocturnal enuresis is a medical condition where the bladder empties during sleep. It is more common in women, older adults, and people with Down syndrome. It happens when the bladder needs to empty during sleep, but the brain is unable to wake the person to the bladder signals. The wet bed is outside the person’s control, but still may cause embarrassment, shame, frustration, and disturbed sleep. It can also affect intimate relationships.

What causes nocturnal enuresis in teenagers and adults?

There are different reasons why the bladder may need to empty at night:

• Normally the kidneys produce less urine at night than they do during the day. If the individual is not able to produce enough of a hormone that reduces urine production at night, the kidneys will continue to produce daytime amounts of urine and the bladder will not be able to hold it all.  
• If the bladder is smaller than it should be, or if the muscles in the bladder are tightening during bladder filling (they should be relaxed during bladder filling) the bladder will not be able to hold onto the urine and will empty. 

If either or both these problems are present, along with an inability to wake to the bladder signals the bladder will empty into the bed.

Are there any other causes for enuresis in teenagers and adults?

• Urinary tract infections can cause nocturnal enuresis. This is because they are associated with an increased need to pass urine.
• Fizzy drinks and drinks with caffeine in them (tea, coffee, cola, hot chocolate and many energy drinks contain caffeine) may irritate the bladder and cause wetting. Caffeine also has a diuretic effect (it encourages the kidneys to make more urine).
• Alcohol has a diuretic effect, and it has an impact on sleep. It may make it more difficult to wake to bladder signals.
• Constipation can result in difficulty emptying the lower bowel. The retained stools then put pressure on the bladder, which is in turn cannot hold as much urine as usual, resulting in wetting.  If the constipation is very severe, it can partially block the urethra (the pipe that connects the bladder to the outside), so the individual is not able to fully empty their bladder.
• Sleep apnoea (stopping breathing for a short time when asleep) and snoring have been linked to nocturnal enuresis. Treatment for this may help.
• Smoking, being overweight, high blood pressure and not taking much physical exercise have been linked to nocturnal enuresis in women.
• If there is a blockage in the bladder or water pipe (urethra), then nocturnal enuresis can happen. Blockages can be caused by stones in the bladder or urethra, or an enlarged prostate in men.
• Type I and type II diabetes (sugar diabetes) can cause nocturnal enuresis, particularly if poorly controlled. This is because high blood sugar levels result in increased urine production.
• Some medications, including diuretics (medicines that increase urine production), medicines used to improve sleep and some that are used for mental health conditions have been linked to nocturnal enuresis. If you think that your medicine may be causing the condition, speak to your healthcare professional before stopping your medication.

For many teenagers and adults there may be more than one cause for the nocturnal enuresis.

Can anything be done to help the nocturnal enuresis?

There are different treatments for nocturnal enuresis. If you have had treatment before that has not worked, it does not necessarily mean that there are no options for you now. The treatment you are offered will vary according to what your healthcare professional thinks is causing the problem. Some people need more than one treatment, and some may need to be referred for further investigations or to a specialist service for support.

Is there anything I can do to help myself with nocturnal enuresis?

Sometimes simple changes to lifestyle can be helpful. These include:

• Drink plenty of water-based rinks during the day.
• Avoid all drinks in the last two hours before bed.
• Avoid drinks that contain caffeine or alcohol and fizzy drinks.
• If you are overweight, try to lose some weight.
• If you are taking medication, discuss this with your healthcare professional.
• Try to avoid constipation, by ensuring you are drinking enough water-based drinks and that you have sufficient fruit, vegetables and fibre in your diet. If constipation is a problem, talk about the options with a pharmacist or your healthcare professional.

What other options are there to treat nocturnal enuresis?

If the measures above do not work, then treatments that target the underlying cause of the nocturnal enuresis may be an option. 

If your kidneys are making too much urine at night, a medication called Desmopressin may be suitable, if you are under 65 years old. For older adults Noqdirna may be an option. Both must be prescribed by a healthcare professional. They are not suitable for everyone, and older adults may need blood tests before and after starting treatment.

If your bladder is not storing urine as effectively as it should, then medication for this may be helpful. There are some medicines (called anticholinergics) that help the bladder wall muscle to stay relaxed while the bladder is filling and so help it to store urine more effectively.

If the nocturnal enuresis is caused by another problem, such as diabetes, a blockage in the urinary system, sleep apnoea or a side effect of medication you are taking, your healthcare professional may be able to suggest options or refer you to a specialist service.

Where can I get more support and information?

If you have nocturnal enuresis, do not suffer in silence, but speak to your healthcare professional. They may be able to offer an assessment and recommend treatment or refer you to a specialist.

It is important not to ignore any new bladder and/or bowel symptoms as these may suggest a different underlying condition that can and should be treated.

You can find more information on the Bladder & Bowel UK website – www.bbuk.org.uk/adults/adults-resources – or contact the Bladder & Bowel UK helpline for free confidential advice – www.bbuk.org.uk/enquiries/. 

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Children wet the bed because they can’t be bothered to get up at night? This is a myth.

Children do not wet the bed because they are too lazy or naughty to get up and go to the toilet at night.  Children who have bedwetting are not able to wake up to the bladder signalling that it needs to empty.

If children are frustrated by bedwetting, or worried that they are going to get into trouble because of it they may respond by trying to hide the problem and any wet clothes or sheets. If children are using disposable nappies or pants, they may sometimes use these when they are awake. This might be because they are frightened to go to the toilet in the dark, or they are worried about waking other family members.

Children should not be punished for bedwetting. This will not help and may even make the problem worse. Bedwetting is not caused by anything you or child has done or is doing wrong.

Bedwetting caused by deep sleep? This is a myth.

Children who wet the bed are not able to wake to the signals to the bladder that it needs to empty. However, this is not usually a problem of sleeping too deeply, rather it is a problem of not being able to wake up. 

Although the children continue to sleep through bladder emptying, the signals from the bladder to the brain that the toilet is needed do  disturb their sleep. Therefore, children who are wet at night tend to have sleep that is of a poorer quality than children who are dry at night. This can make them more tired and may make it even more difficult for them to then wake up when their bladder needs to empty.

Bedwetting caused by drinking too much during the day? This is a myth.

Many children do not drink as much during the day as is recommended. If this is the case, the bladder wall muscles do not get the opportunity to stretch well during bladder filling, so the bladder may not be able to hold as much urine as it should. If the bladder is small it cannot hold all the urine made overnight, increasing the likelihood of wetting.

Children who are not drinking well are also more likely to be constipated. About half of children with bedwetting also have constipation. Treatment for constipation may help improve bedwetting for some children and may make treatments for bedwetting to more effective.

Bedwetting caused by drinking too much in the evening? This may be true.

Having a drink just before going to sleep may make bedwetting more likely to happen. Therefore, while it is recommended that children should drink plenty of water-based drinks during the day, they should avoid having a drink in the last hour before they go to sleep. It is also advised that they do not eat in the last hour before going to bed.

Bedwetting is caused by drinking the wrong type of fluids? This may be true.

Fizzy drinks and drinks with caffeine in them (tea, coffee, chocolate and many energy drinks) can irritate the lining of the bladder. Caffeine can also increase the amount of urine produced, increasing the number of visits to the toilet. Therefore, fizzy and caffeinated drinks should be avoided, particularly in the evenings.

Some people also advise against blackcurrant squash and other dark coloured drinks. There is a natural ingredient in blackcurrant that may irritate the bladder. However, it does not affect everyone. All children are different. Therefore, if you think that bedwetting might be linked to the type of drink your child is having, try to avoid that drink for a few days and see if the bedwetting improves. If it does there may be a link.

Taking the child to the toilet during the night will cure bedwetting. This is a myth.

Many parents take their child to the toilet during the night. While this may keep the bed dry, and can be useful when sleeping away from home, it does not help with the underlying cause of the bedwetting.  Furthermore, there is a suggestion that waking children for the toilet during the night may make the bedwetting continue. This is because it is not teaching the children to wake to their bladder signals and may encourage them to pass urine during sleep, if they are not fully awake when taken to the toilet.

Waking or lifting children during the night is no longer recommended. However, if your child does wake independently during the night, it can be helpful to encourage them to use the toilet before going back to sleep.

Children with disabilities cannot be treated for bedwetting. This is a myth.

Children with disabilities should have typically developing bladder and bowels. Once they have been dry in the day for six months or more and are over five years old, they should be offered assessment and support for bedwetting.  

Bedwetting is caused by stress or psychological problems. This may be the case for some children.

Night-time wetting can start after a period of dry nights where there has been a stressful life event. However, it is more common for children to experience stress about the ongoing wetting than it is for stress to cause the wetting. Therefore, it should not be assumed that when the stress reduces the wetting will get better. All children who have bedwetting should be offered assessment and appropriate treatment.

Bedwetting will get better on its own as children get older.  This might happen for some children.

Bedwetting is more common in younger children, with about 80% of children becoming dry at night before they reach their fifth birthday. After this age, many who continue to wet the bed only do so occasionally. These children are most likely to get better on their own. However, children who are wet two or more nights a week should be treated.

Bedwetting does not affect teenagers or adults. This is a myth.

Bedwetting can affect people of all ages. If older children, teenagers or adults are experiencing bedwetting they should talk to their healthcare professional about the options open to them. 

There is more information on bedwetting in adults on the Bladder & Bowel UK website –  www.bbuk.org.uk/adults/adults-resources – and there will be more blog posts published as part of this series for World Bedwetting Week.

Bedwetting is a difficult condition for many people. This is true.

Bedwetting can cause embarrassment and shame. It is associated with reduce self-esteem, bullying, difficulty sleeping away from home and disturbed sleep. It can also be expensive due to increased washing, and the need for extra bedding and pyjamas.   

Bedwetting can and should be treated. This is true.

Children who are more than five years old who are still wet at night should be offered an assessment of their bladder and bowel health and basic advice. If making simple changes as outlined above does not help, then there is treatment available. Ask your healthcare professional for advice and support. They may also be able to refer you for specialist help if required.

You can find more information on the Bladder & Bowel UK website – www.bbuk.org.uk/children-young-people/resources-for-children – or contact the Bladder & Bowel UK helpline for free confidential advice at https://www.bbuk.org.uk/enquiries. There is information on how to speak to your healthcare professional from Stop Bedwetting – www.stopbedwetting.org.

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Many people believe that bedwetting is something that children will grow out of as they get older without any treatment. While this is true for many children who are only wet occasionally, it is less likely to be the case for those who are wet more often. Children who are wet five or more nights a week are the ones who are least likely to just become dry with time. If children are wet two or more nights a week after their fifth birthday, then the condition can be treated.

While bedwetting can be a difficult problem to manage and frustrating for both the child and their family, it is important to remember that bedwetting is a recognised medical condition. It is not caused by laziness, naughtiness or anything the child or the family has done or is doing that is wrong.

Bedwetting is difficult for children

While some children, particularly younger ones are not bothered by bedwetting, many find it distressing and difficult. It causes embarrassment and many worry about being teased or bullied if others find out. For this reason they may be reluctant to talk to anyone about it, including their healthcare professional. Anxiety about others finding out may also make them want to avoid normal childhood activities including sleepovers and residential trips with school, or groups such as brownies or cubs. Feeling the need to keep the wetting a secret is difficult for many, with bedwetting consequently affecting friendships and reducing individuals’ self-esteem.

Bedwetting can disturb sleep. Although the affected children are not able to wake up to their bladder signals, the messages from the bladder that wants to empty to the brain disrupt sleep. This means sleep for children affected by bedwetting is often of less good quality, resulting in tiredness during the day. That may, in turn, be associated with more difficulties with behaviour and learning in school than other children experience.

The good news is that successful treatment may help with all these problems.

Bedwetting is difficult for families

Many parents worry about the impact of bedwetting on their children. However, the bedwetting is not easy for families to manage either. Over a third of those responding to a Bladder & Bowel UK survey for World Bedwetting Week in 2022 said that they were worried about getting less sleep themselves due to their child’s bedwetting. Other issues highlighted in the same survey included additional washing, which, along with changing the bed more frequently, is time consuming. Having to purchase additional underwear or pyjamas and bedding were concerns and these, along with the increased laundry, have clear financial impacts, which are particularly difficult for many and compounded by the current rising costs of living. Some families chose to use disposable products to contain the wetting at night, but these also impact on family budgets.

Staying away from home is more problematic for families who have a child who is wetting the bed. Two thirds of families responding to the Bladder & Bowel UK survey said that they would take their own waterproof mattress cover with them when going on holiday and over half would take extra clothes.

Rarely bedwetting is a sign that there might be something else wrong 

Bedwetting, particularly if it starts again suddenly after a time of being dry at night, may indicate an underlying medical problem. Bedwetting may be a symptom of a urinary tract infection. Because bacteria that cause the infection irritate the bladder lining, affected children to need to go to the toilet more frequently than usual and with more urgency. If they are not able to respond to the sudden and unexpected need to empty their bladder while asleep they will wet the bed. 

Constipation is also linked with bedwetting. If the rectum (the part of the bowel near the bottom) is not emptied fully, or if stools build up there, then there is less space for the bladder to stretch and hold onto all the urine that is produced overnight, resulting in wetting. Constipation in children should be treated with laxatives, but these do need to be prescribed by a healthcare professional in all children under 12 years old. 

Very rarely bedwetting may indicate a more serious underlying health issue or be caused by stress. Therefore, if your child suddenly starts to wet the bed after being dry at night for weeks or months, ask their healthcare professional for advice.

Where can families go for help?

Children’s healthcare professionals should be able to offer an initial assessment and advice on simple measures that may help improve bedwetting. If these are not effective, they can provide further support and treatment or refer to a specialist service. Therefore, this World Bedwetting Week if your child is affected by bedwetting, ask their GP or school nurse for support.

You can also find more information on the Bladder & Bowel UK website – www.bbuk.org.uk/children-young-people/resources-for-children – or contact the Bladder & Bowel UK helpline for free confidential advice – www.bbuk.org.uk/enquiries. There is information on how to speak to your healthcare professional – www.stopbedwetting.org.

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Bedwetting is considered a medical condition in anyone who is wet more than two nights a week and is five years old or more. There is treatment available for the condition.

Is bedwetting a normal part of growing up?

Children cannot learn to be dry at night in the same way as they do during the day.

To become dry at night the kidneys must be able to reduce overnight urine production. The bladder must be large enough and work well to be able to hold all the urine made at night. If these are not happening, the affected person must be able to wake up when the bladder needs to empty. If the brain is not able to wake to the person via bladder signals, the bladder will empty during sleep.

Does bedwetting get better with time?

Some children will ‘grow out’ of bedwetting. However, not only is it difficult to predict who will get better if no treatment is offered, but it is also not possible to say when the wetting will stop. There is evidence that children who are wet most nights are least likely to get better without treatment. 

Does bedwetting affect older children and adults?

Bedwetting is not just a problem for young children. ‘Primary enuresis’, which is the medical term given to bedwetting that has continued since toilet training, affects about 3% of adolescents and about ½ – 1% of adults. 

Why might bedwetting become a problem after dry nights?

If bedwetting starts after a child, young person or adult, has been dry at night for at least six months, it is called ‘secondary enuresis’. Sometimes there is an obvious trigger for this, like a urinary tract infection. And sometimes it is not possible to work out why it has started. Rarely, there may be an underlying medical issue, which needs treatment. That is why it is important to discuss any new bedwetting with a healthcare professional.

What treatments are there for bedwetting?

Your healthcare professional may suggest some simple lifestyle changes to help. There is more information about these in the Bladder & Bowel UK blog – www.bbuk.org.uk/nutrition-and-hydration-tips-for-children. However, many do need one or more of the different treatments available.

• Medication:

There is a medication called Desmopressin that helps to tell the kidneys to make less urine overnight.  This is available on prescription from your healthcare professional. There is more information about it in the Bladder & Bowel UK leaflet Understanding Desmopressin (Desmomelt) for parents and carers – www.bbuk.org.uk/wp-content/uploads/2021/04/Understanding-Desmopressin.pdf.

• Alarms:

Alarms make a loud noise and or vibrate when they sense the bladder leakage. Some alarms can be attached to pyjamas (body-worn alarms) or they have a mat that goes under the top sheet (bed mat alarms).

The noise is designed to wake the child, young person or adult as their bladder starts to let go, so that they can get up and go to the toilet. They can take some time to be effective. While it is not clear exactly how they work, they do help some to learn to wake to the bladder signals. Others learn to hold on all night.

There is more information about using alarms as a treatment for bedwetting here – www.bbuk.org.uk/wp-content/uploads/2019/04/Using-a-wetting-alarm-for-toilet-training.pdf.

What other treatment options may be needed for bedwetting?

If there is any constipation this will usually be treated first. That is because a constipated bowel can put pressure on the bladder and cause bedwetting. 

Daytime problems, like dampness, wetting, needing the toilet in a hurry or frequently should be addressed. As these can affect how the bladder works at night. Many children will be asked to adjust their fluid intake and toileting habits to see if this help. Some children may need medication to treat daytime wetting.

Some need other medication to help the bladder work well and some children need to have more than one treatment. Therefore, bedwetting in anyone over five years old should be assessed by a healthcare professional.

Your Healthcare professional will talk to you about the options available and help you and your child chose which treatment to try first.

Where can I find more information about bedwetting?

There is more information about bedwetting on the Bladder & Bowel UK website – www.bbuk.org.uk/children-young-people/resources-for-children – and in other blogs on the Bladder & Bowel UK website – www.bbuk.org.uk/?s=bedwetting. There is also information at Stop Bedwetting – https://stopbedwetting.org – and at World Bedwetting Week – www.worldbedwettingweek.com.

Where can I get more advice and help?

Your child or young person’s GP, school nurse or health visitor should be able to provide more information and initial assessment. They may be able to refer your child to a local service for support. You can also contact the Bladder & Bowel UK helpline for free confidential information and advice via the webform – https://www.bbuk.org.uk/helpline-enquiries – or on the telephone at 0161 214 4591.

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What is bedwetting?

Bedwetting is when the bladder empties during sleep. It is not the child or young person’s fault, it does not happen because of something you or they are doing wrong and it is a recognised medical condition in anyone over the age of five. However, the support and basic advice for bedwetting described here are also appropriate for families of younger children who are toilet trained in the day.

Why does it happen?

There are different causes for bedwetting:

• Not being able to wake fully:

The brain doesn’t signal that it needs to empty. However, most children and young people can sleep through the night without needing to go to the toilet.

• Bladder size:

The bladder cannot hold the urine during the night.

Some children with bedwetting also have problems with their bladder when they are awake. These children may experience some urine leaking during the day: they may get damp or wet underwear. Some may go to the toilet more often than usual (frequency) or they may have to get there more quickly than usual (urgency). This can appear to families as if they are leaving it to the last minute to go to the toilet, which is not usually the case: it is the bladder ‘twitching’ at any point during filling, which causes a sudden, strong and unexpected need to get to the toilet quickly.

Making too much wee

Most people make less urine during the night. The bladder can hold all that is produced while asleep, however, if the kidneys are making too much urine while the child or young person is asleep and they are not able to wake to the bladder signals, the bed will get very wet.

Constipation

Constipation can also cause bedwetting or make it worse. This is because the full bowel can put pressure on the bladder. A normal poo is soft, easy to pass, and its colour will be any shade of brown or dark green. Most, children over the age of three open their bowels no more than three times a day and no less than three times per week. Constipation can develop if the poo becomes difficult to pass.

Other signs and symptoms that might indicate constipation include

• Pooing less than three times a week or more than three times a day.
• Soiling (any amount of poo in the underwear).
• This may get better for a few days after doing a large poo.
• A painful bottom, or pain when doing a poo.
• A swollen or bloated tummy. Passing large hard poo which may block the toilet, or passing only small poos (soft or hard) or poos of different sizes and consistencies.
• Appearing to strain to poo or to avoid pooing.
• Poor appetite.
• Angry or irritable mood.

When you think your child may be constipated, speak to their healthcare professional. Constipation in children and young people usually needs to be treated with laxatives.

Bladder & Bowel UK’s Top Ten Tips:

Simple and effective steps you can try now to help with bedwetting.

1. Encourage your child to drink well during the day, they should have 6–8 water-based drinks per day. Most school age children should have 1.5 litres of drink in the day which can be divided into their 6-8 drinks.
2. Avoid drinks that contain caffeine (tea, coffee, cola, hot chocolate and energy drinks).
3. Steer clear of any fizzy drinks, except as an occasional treat.
4. STOP drink in the hour before they go to sleep.
5. STOP all food in the hour before they go to sleep.
6. STOP screen use including TV in the hour before bed.
7. Make sure your child goes for a wee just before they go to sleep.
8. Ensure good bedtime routines so that your child goes to bed at about the same time most nights.
9. Try without night-time pants/nappies for three or four nights. If your child is dry, try without them for longer.
10. Speak to your GP or school nurse and ask for treatment if there are any signs of constipation. 

Where can I find more information?

We are a national charity that provides information about bladder and bowel conditions for people of all ages. Information on our website is free to access, download and print – www.bbuk.org.uk.

Information on bedwetting is available – www.bbuk.org.uk/children-young-people/resources-for-children.

There is also information about how to speak to your healthcare professional about bedwetting on the Stop Bedwetting website – www.stopbedwetting.org. There is information about World Bedwetting Week – www.worldbedwettingweek.com.

Bladder & Bowel UK produce a free quarterly electronic newsletter for the public, which is full of interesting articles, suggestions and information for people affected by bladder and bowel conditions.

Sign up here – www.bbuk.org.uk/newsletter

You can contact the Bladder & Bowel UK confidential helpline by filling in the web form – www.bbuk.org.uk/helpline-enquiries – or phoning us on 0161 214 4591.

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