The definition of bedwetting, or what’s technically known as nocturnal enuresis is: the involuntary loss of urine at night, in the absence of organic disease, at an age where a child could be expected to be dry, which by consensus, is at a developmental age of 5 years.
It’s often associated with parental disapproval, sibling teasing, repeated treatment failure, lowered self esteem, impact on mental well being, and impact on social life. There’s even evidence that there’s an increased risk of physical and emotional abuse.
If a child has never been consistently dry, this is known as primary nocturnal enuresis.
This may, and often can occur in teens who sleep deeply, and sometimes may be due to problems due to neural integration, meaning, they don’t wake up in response to the signals that are telling the brain they need to urinate. This suggests that there may actually be a developmental delay in the way the brain and body communicates.
There’s usually no disease process associated with it, but there are a number of risk factors that seem to be associated with primary nocturnal enuresis. These include: A family history of bedwetting, being a deep sleeper, and stopping exclusive breastfeeding before the age of 4 months.
Secondary nocturnal enuresis is when a child has been dry for at least 6 months but then reverts. The most common causes of this are emotional stress or a medical conditions such as a bladder infection.
Conventional treatment for nocturnal enuresis is usually one of the following three things, or a combination of all: Behavioral therapy, alarm therapy, and pharmacological therapy.
However, there’s still a major lack of evidence to support most of these conventional approaches. Because of this, parents look for other natural options. One of which is Chiropractic.
Most chiropractors, especially those who have been in practice for a long time, have been told more than once by patients that have helped their kid with bedwetting; sometimes even after only one or a couple of visits.
Because when this happens there is usually a very spontaneous cessation when chiropractic does seem to help, it makes it very hard to say if chiropractic is actually helping or if it's just a lucky coincidence.
We do know from the research, that chiropractic absolutely improves brain and body function, so it’s very logical that bedwetting could potentially improve it.
Research first starts is with anecdotal evidence, of which, here at Sarpy Chiropractic and virtually every chiropractor who specializes in pediatrics has. Anecdotal evidence means, we are seeing something happen often enough, that it should then lead to the next step of research which is case series and case studies.
Let's look at what studies have been done so far. In one particular study, they followed 33 patients for 12 months. 22 (or 66%) showed a reduction during the follow up period. This is a great result. But the argument with case series and case studies is, we can’t rule out natural progression, and so we need to look at the next level of science, which is experimental trials.
So in a 2011 Cochrane review, they looked at a variety of different interventions for bedwetting. They looked at all of the available case studies, case series and experimental trials that were done. They reported that there was weak evidence that suggested that chiropractic may help bedwetting.
Weak means there is not enough evidence to come to a solid conclusion, but from what they did see the evidence was favorable. And they based this decision on a single clinical trial that was performed (which is very rare, meaning that it was a very strong clinical trial). This means that obviously, way more research needs to be performed, but what’s out there is actually very favorable. We do need more evidence with multiple studies showing the same thing before reviewers will make strong conclusion.
So what was this one major study? It was a controlled clinical trial that looked at 46 kids with bedwetting. 31 kids received chiropractic care for 10 weeks, and the chiropractic care was delivered by 2 final year chiropractic students at a chiropractic school. The other 15 kids were in the control group and received a “sham” or fake adjustment. Wet night frequency was recorded for two weeks prior to this study starting, to get baseline readings, and then recorded all the way through the trial, and for 2 more weeks after the trial finished.
The chiropractic group went from 9.1 wet nights to 7.6 wet nights after their treatment was performed. The control group stayed the same as what they started. Now, 1.5 nights difference doesn’t sound huge, but when reviewers looked at the data closer, 25% of the chiropractic group showed more than a 50% reduction in wet night frequency, and of course the control group showed no such reduction. That’s a big deal for those 1 in 4 kids. That’s a life changer.
It is a small study, but yet the Cochrane review, after studying the data, did state, that the kids in the chiropractic group, were more likely to improve than the control group kids. And the difference between the two groups was significant.
Now, remember, there are limitations, such as this being a small study, but also the fact that students were doing the adjusting could mean that the results should be even better. This study suggests that it is, in fact, very likely, that chiropractic care can help some children suffering from bedwetting, but not all.
So, parents with children suffering from bedwetting should consider getting their children checked by a chiropractor, because for that child, it could have a huge impact on their quality of life. There’s really nothing to lose, because, as we’ve spoken about on other blogs and podcasts, chiropractic has an enviable safety record, especially when it comes to chiropractic and kids. It’s as close to a risk free treatment as anything else that is out there.
Comments
Post a Comment