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Medical Author:

John Mersch, MD, FAAP

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Most people (80%) who wet their beds, wet only at night. They tend to have no other symptoms other than wetting the bed at night.

Other symptoms could suggest psychological causes or problems with the nervous system or kidneys and should alert the family or health-care provider that this may be more than routine bedwetting.

• Wetting during the day
• Frequency, urgency, or burning on urination
• Straining, dribbling, or other unusual symptoms with urination
• Cloudy or pinkish urine, or blood stains on underpants or pajamas
• Soiling, being unable to control bowel movements (known as fecal incontinence or encopresis)
• Constipation

Frequency of urination is different for children than for adults.

• While many adults urinate only three or four times a day, children urinate much more frequently, in some cases as often as 10-12 times each day.
• "Frequency" as a symptom should be judged in terms of what is normal for that particular child.
• Equally important, "infrequent voiding" (less than three times urinating/day) can be a sign of other underlying problems.

Fecal impaction may present as constipation. Both fecal impaction and constipation cause straining, which can injure the nearby urinary sphincters, muscles that control flow of urine out of the body.

• Fecal impaction occurs when feces becomes so tightly packed in the lower intestine (colon) and rectum that passing a bowel movement becomes very difficult or even impossible. If the stool is passed, it is often a painful experience.
• The hard, tightly packed feces in the rectum can press on the bladder and surrounding nerves and muscles, interfering with bladder control.
• Neither fecal impaction nor constipation is that unusual in children.
• A strict bowel regimen can often alleviate bedwetting.

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