The Role of the Physician for Daytime Bladder Accidents:
Bladder accidents during the day is called Diurnal Enuresis. Nighttime bladder accidents is termed Nocturnal Enuresis. Diurnal enuresis is more frustrating because it would appear more likely to be under conscious or willful control than accidents occurring when the child is unconscious in sleep. Also, it is much less common than bedwetting. A physician should be sought to rule out obvious physical causes such as diabetes, cancer, or an occult (closed) spinal-bifida. These potential causes are rarely involved.
The role of an Enlarged Colon as a Cause for Diurnal Enuresis:
The recent publication of “It’s No Accident: Breakthrough Solutions to Your Child’s Wetting, Constipation, UTIs, and Other Potty Problems (2012)” by Pediatric Urologist Steve J. Hodges, MD at the Wake Forest Medical School is a must read for parents and physicians who encounter diurnal enuresis. It is highly readable and lends tremendous insights as to the various cultural practices that lead to this problem. The major thesis is that an enlarged colon occasioned by constipation or encopresis crowds the bladder making it more unstable and subject to sudden releases of urine. Playing, jumping, running, laughing, sneezing, etc. can become more immediate or proximal causes of daytime bladder accidents.
The Clean Kid Manual With Two New Additional Chapters on Diurnal and Nocturnal Enuresis:
Dr. Hodges and I are now collaborators for reaching out to a much larger audience including both parents and physicians. I had much earlier done considerable research on validating and extending the use of the bedwetting alarm by parents. Over the years I was occasionally frustrated by inadequate responses and frequent relapses to the alarm for nocturnal enuresis. As I read Dr. Hodges’ book I was excited to read medical vindication for my views and the useful role for suppositories and enemas in treating encopresis. I had long ago cautioned parents that, if your child has Encopresis (soiling) or hard, large or difficult bowel movements, those issues must be managed first. Often, but not always, resolution of the encopresis would be followed by resolution of the child’s diurnal and nocturnal enuresis. If not, then my two new treatment chapters in the Clean Kid Manual could then be followed for further resolution.