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Many children and adults know the humiliation and embarrassment of waking up in a urine-soaked bed The stigma attached to a "Bed Wetter" is something which, often times, follows a child throughout his adolescent/teen years and sometimes, even into adulthood. The fear and anguish that awaits with the rising of the sun is a certainty in many lives.

The majority of children and adults with this problem, known as Nocturnal Enuresis, tend to be withdrawn and possess very low self-esteem This negative effect touches many aspects of their lives

They generally make few friends and do not do well in school. A bedwetter will decline offers to sleep over at a friends house or go on camping trips The very real fear of being "discovered" by their peers would be too devastating to risk the attempt Their academic performance may suffer as a direct result of the stress, tension, and lack of self confidence associated with this condition. All of this negativity can and will affect a child's psychological development.

Many studies and surveys have been conducted producing the following profile:* The average bedwetter is between 4 and 14 years old About 15% of children wet the bed after the age of 3 Two out of three bedwetters are boys It is common for the child to wet within 2 1/2 hours of going to sleep A bedwetter will do so 1-4 times a night, 5-7 nights a week

Bedwetting may be inherited. Normally, bedwetting ceases by puberty Over years, many approaches to "cure" this problem have been advised. They include: restricting liquids before bedtime, waking the child at regular intervals to go to the restroom, implementing bedwetting "alarms", threatening punishment, leaving on a night light, offering, and using prescribed medications.

There may be several reasons for nocturnal enuresis. The most common cause is a lag--or slow development of bladder control. Other causes include: a urinary tract or abnormality, small bladder capacity, emotional distress and tension, and problems. Some neurological problems relating to bedwetting may be to a spinal subluxation or misalignment of the spine in the upper lumbar or sacrum of the spine itself. This region is located in the lower back area and directly affects the of the bladder and kidneys.

Interesting Studies

The following studies are provided by International Chiropractic Pediatric Association Results of the present study strongly suggest the effectiveness of chiropractic treatment for primary nocturnal enuresis.

Twenty-five percent of the treatment-group children had 50% or more reduction in the wet night frequency from baseline to post-treatment while none among the control group had such reduction. The post-treatment mean wet night frequency of 7.6 nights/ 2 wk for the treatment group was significantly less than its baseline mean wet night frequency of 9.1 nights/2 wk.

For the control group, there was practically no change (12.1 to 12.2 nights/2 wk) in the mean wet night frequency from the baseline to the post-treatment. Improvement was obtained after the first adjustment and remained stable. The treatment effect, i.e. change from bed wetting to non bed-wetting, in children that had never been dry was large and relatively immediate.

Examination found fixation in L3 and both SI joints, following the restoration of SI function the patients mother reported the patient was now aware of bladder distention approximately 30 minutes before it was necessary to void. A slight loss of bladder sensitivity occurred 4 months after the release from treatment and responded immediately to manipulation. In 171 children suffering with enuresis, the average number of bed wettings per week was 7, while at the end of the study the average number of bed wettings per week was reduced to 4.

Additionally, 1% of patients were considered "dry" at the beginning of the study, while 15.5% were considered "dry" at the end of the study. A controlled clinical trial of 46 primary enuretic children was over a period of 14 weeks to assist in evaluating the influence of chiropractic care. Subjects were between five and 13 years of age.

There were 31 in the treatment group, which received a spinal evaluation and/or adjustment at a minimum of every ten days. The remaining 15 subjects were control which came in with the same frequency but received a "sham" adjustment over an equal period of time. Chiropractic care was rendered for ten weeks, preceded and followed by a 14-day non-treatment baseline.

The mean post-treatment frequency of wet nights for the treatment group was significantly less than its pre-treatment frequency; while there was practically no difference between mean pre- and post-frequency for the control group.

Subjects receiving chiropractic care averaged a 17.9% reduction in wet nights for the control over the same period of time. The patient's enuresis resolved with the use of manipulation. This happened in a manner that could not be attributed to time or placebo effect.

Gemmell HA; Jacobson BH; Chiropractic management of enuresis:> time-series descriptive design. J Manipulative Physiol Ther 1989; 12(5):386-9 / Medline ID: 90111458 2. Borregard PE; neurogenic bladder and spina bifida occulta: a case report. J Manipulative Physiol Ther 1987; 10(3): 122-3 / Medline ID: 87282103 3. Leboeuf C; Brown P; Herman A; Leembruggen K; Walton D; Crisp TC; Chiropractic care of children with nocturnal enuresis: a prospective outcome study. J Manipulative Physiol Ther 1991; 14(2):110-5 / Medline ID: 91210682 4. Limes, D.H., "Chiropractic In The 21st Century, The Past, The Present And Future" J Austr Chiro Assoc., 1989 19(2):49-54 5. Blomerth PR; Functional nocturnal enuresis. J Manipulative Physiol Ther 1994; 17(5): 335-8 / Medline ID: 95016316 6. Reed WR; Beavers S; Reddy SK; Kern G; Chiropractic management of primary nocturnal enuresis J Manipulative Physiol Ther 1994; 17(9): 596-600 / Medline ID: 95190413 7. Reed WR; Beavers S; Reddy SK; Kern G; Chiropractic management of primary nocturnal enuretic children. Proceedings of the National Conference on Chiropractic & Pediatrics. 1993 Oct. pp 64-82.


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