How is Constipation Related to Bed Wetting?

Bedwetting (also called nocturnal enuresis or NE) is defined as “intermittent incontinence during sleep” (1). If your little one is suddenly dealing with accidents overnight, you aren’t alone! Studies show that 5-12% of school age children struggle with chronic bedwetting (1). 

Although bedwetting could be related to a smaller bladder, hormonal changes, or issues with sleep-wake cycles, it also has an interesting connection to constipation. Constipation might not seem connected, but it can actually lead to bedwetting or be caused by the same underlying problem.

And if untreated, chronic constipation and bed wetting could impact your little one’s physical health, mental health, and even school performance (1). In this post, we’ll cover how bed wetting is related to constipation and how to relieve symptoms to help your little one thrive.

How Constipation Can Contribute to Bed Wetting

Research shows that kids who struggle with chronic constipation are more likely to have issues with bladder control than kids with regular bowel movements (1). Although this connection is complex, there are a couple key ways constipation contributes to bed wetting:

• Constipation may lead to weak bladder muscles.The bladder and rectum share the same set of nerves to control their functions. When constipation fills the rectum, it can send extra signals down those shared nerves which makes the bladder contract when it shouldn’t and become weaker over time.

• Constipation puts more pressure on the bladder.When your little one is constipated, they might be holding on to a lot of stored stool in their rectum, eventually becoming distended and pushed up against the bladder. This pressure makes it difficult to hold urine.

• Poor neuromuscular function. In some cases, constipation and bedwetting may both stem from the same root cause of poor pelvic muscle coordination. If your kiddo has under-developed pelvic floor control, this might impact their ability to have regular poops and control night-time leakage.

Steps to Relieving Constipation-Induced Bed Wetting

Now that we understand the link between constipation and bedwetting, addressing constipation becomes an important step in helping your child stay dry overnight. In fact, research shows that once constipation is properly treated, bedwetting improves in about 63% of children (2).

Here are some practical steps to improving constipation-related bed wetting:

Work with a pelvic floor physical therapist 

Building better control over the pelvic muscles can make a big difference—both for bowel movements and for nighttime dryness. A pediatric pelvic floor therapist can guide your child through simple exercises to strengthen the muscles that support bladder and bowel control. 

If you’ve already worked on diet changes without much success, this might be the next helpful step.

Introduce high-fiber foods

Fiber helps soften stool and make it easier to pass. With 95% of kids not eating enough fiber, it’s a likely culprit of their constipation and bed wetting. 

Easy ways to introduce fiber to kids is to choose high fiber carbs (bagels, bread, rice, etc), serve high fiber fruits (berries, pears, kiwi), and utilize nuts and seeds in every meal (trail mix, chia seeds, flax seeds).

Increase water intake

When dealing with bed wetting, your natural instinct might be to decrease your kiddo’s water intake. But if constipation is the root cause, they need water to help soften their stools. 

Encourage your child to take small sips throughout the day, focusing most of their water intake earlier in the day when possible.

Focus on gut health with prebiotics and probiotics

A healthy gut supports healthy digestion. Foods that contain probiotics (like yogurt or kefir) and prebiotics (like bananas, oats, or asparagus) help feed the “good” bacteria in the gut. 

Together, this leads to production of short-chain fatty acids which reduce inflammation in the gut and help the intestines move stool more efficiently.

Summary

There is a surprising connection between constipation and bed wetting due to the shared nerve and muscular function of the bladder and rectum. Focusing on a high fiber, gut healthy diet and working to strengthen the pelvic muscles can help your little one become regular and stay dry overnight.