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Bedwetting (Enuresis)

Health Topics

bedwettingPeer Reviewed Publications:

1) Chiropractic management of primary nocturnal enuresis. Reed WR, Beavers S, Reddy SK, Kern G. JMPT Vol. 17, No. 9 Nov/Dec 1994. This was a controlled clinical trial of 46 enuretic children that were placed under chiropractic care. The children were under care for a 10 week period preceded by and followed by a 2 week nontreatment period. Participants: Forty-six nocturnal enuretic children (31 treatment and 15 control group), from a group of 57 children initially included in the study, participated in the trial. Results:...25% 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.

2) Nocturnal enuresis: treatment implication for the chiropractor. Kreitz, B.G. Aker, P.D., JMPT 1994:17(7): 465-473. A review of the literature of nocturnal enuresis is presented. The author states: “Spinal manipulative therapy has been shown to possess an efficacy comparable to the natural history.”

3) Chiropractic care of children with nocturnal enuresis: a prospective outcome study. LeBouf C, Brown P, Herman A et al. JMPT, 1991;14(2):110-115. 171 Children with a history of persistent bed-wetting at night received eight chiropractic adjustments. Number of wet nights fell from 7/week to 4. At the end of the study, 25% of the children were classified as successes.

4) Functional nocturnal enuresis. Blomerth PR. JMPT 1994:17:335-338. Eight-year-old male bed wetter. Lumbar spine was manipulated once and at 1 month follow-up there was complete resolution of enuresis. “This happened in a manner that could not be attributed to time or placebo effect.”

5) Neurogenic Bladder and spinal bifida occulta: a case report. Borregard PE. JMPT 1987; 10(3):122-3. Examination found fixation in L3 and both SI joints, following the restoration of SI function the patientʼs mother reported the patient was now aware of bladder distention approximately 30 minutes before it was necessary to void. A slight of bladder sensitivity occurred 4 months after the release from treatment and responded immediately to manipulation.

6) Chiropractic care of children with nocturnal enuresis: A prospective outcome study. LeBoeuf, C.; Brown, P; Herman, A; Leembruggen K; Walton D; Crisp TC. JMPT, 1991, 14 (2), pp. 110-115. In 171 children suffering from 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.

7) Chiropractic management of enuresis: time series descriptive design. Gemmell HA, Jacobson, BH JMPT 1989; 12:386-389. Case of a 14-year-old male with a long history of continuous bed-wetting that was alleviated (not completely cured) by adjustments.

8) Characteristics of 217 children attending a chiropractic college teaching clinic. Nyiendo J. Olsen E. JMPT, 1988; 11(2):78084. The authors found that pediatric patients at Western States Chiropractic College public clinic commonly had ordinary complaints of ear-infection, sinus problems, allergy, bedwetting, respiratory problems, and gastro-intestinal problems. Complete or substantial improvement had been noted in 61.6% of pediatric patients of their chief complaint, 60.6% received “maximum” level of improvement while only 56.7% of adult patients received “maximum” level of improvement.

9) Epileptic seizures, Nocturnal enuresis, ADD. Langley C. Chiropractic Pediatrics Vol 1 No. 1, April, 1994. This is an eight year old female with a history of epilepsy, heart murmur, hypoglycemia, nocturnal enuresis and attention deficit disorder. The child had been to five pediatricians, three neurologists, six psychiatrists and ten hospitalizations and had been on Depakote, Depakene, Tofranil and Tegretol. Birth was difficult including a cesarean under general anesthesia. Mother was told the baby was allergic to breast milk and formulas and stayed on prescription feeding. The doctors told the mother the girl would never ride a bike or do things like normal children do. The child was wetting the bed every night and experiencing 10-12 seizures/day, with frequent mood swings, stomach pains, diarrhea and special education classes for learning disabilities. Chiropractic adjustments: C1 and C2 approximately three times/week. After two weeks of care the bed-wetting began to resolve and was completely resolved after six months. She was also leaving special education classes to enter regular fifth grade classes. Seizures were much milder and diminished to 8-10 per week after one year of care. Patient was also released from psychiatric care as “self managing.” Her resistance to disease in-creased and she can now ride a bike, roller skate and ice skate like a normal child. After medical examinations, she is expected to be off all medication within a month.

Case Studies:

1) Bed-wetting; two case studies. Marko, RB Chiropractic Pediatrics Vol. 1 No. 1 April 1994. Case #0991: Five year old female who had been wetting her bed for six months. She was prescribed antibiotics for what MDs diagnosed as a bladder infection. After the second chiropractic adjustment, she stopped wetting her bed for three weeks. She had a bad fall and began to wet her bed again. After her next adjustment, she has remained dry. Case #0419: Nine year old male who wet his bed almost every day of his life. After the first six months of chiropractic, he would be dry for the next day or two. A change in adjustments to the sacrum resulted in greater improvement. He is now dry for one-half to two-thirds of the nights between the adjustments.

2) ADD, Enuresis, Toe Walking. International Chiropractic Pediatric Association Newsletter May/June 1997. From the records of Rejeana Crystal, D.C., Hendersonville, TN. A six year old boy with nightly nocturnal enuresis (bedwetting), attention deficit disorder and toe walking. He walked with his heels 4 inches above the ground. The medical specialist recommended that both Achillesʼ tendons be cut and both ankles be broken to achieve normal posture and gait. Chiropractic findings included subluxation of atlas, occiput, sacrum and pelvis…after 4 weeks of care both heels dropped 2 inches and the bedwetting frequency decreased to 2-3 times per week. His doctor could not believe how chiropractic care made such a change.

3) Management of pediatric asthma and enuresis with probable traumatic etiology. Bachman TR, Lantz CA Proceedings of the National Conference on Chiropractic and Pediatrics (ICA), 1991: 14-22. A 34-month-old boy with asthma and enuresis had not responded to medical care. More than 20 emergency hospital visits had taken place for the asthma attacks during a 12 month history. Three chiropractic adjustments were administered over an 11 day period and the asthma symptoms and enuresis ceased for more than 8 weeks. The asthma and enuresis reoccurred following a minor fall from a step ladder but disappeared after adjustments. After a two year follow-up, the mother reports no reoccurrence of the asthma or the enuresis. Additional Articles: Chiropractic management of primary nocturnal enuretic children. Reed WR; Beavers S; Reddy SK; Kern G; Proceedings of the National Conference on Chiropractic & Pediatrics. 1993 Oct. pp 64-82. There were 46 primary enuretic children over a period of 14 weeks to assist in evaluating the influence of chiropractic care. Subjects were between 5 and 13 years of age. The 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. The children receiving chiropractic care averaged a 17.9% reduction in wet nights over the control group over the same period of time. Visit: : http://www.chiroweb.com/archives/17/04/04.html for an article on nocturnal enuresis References from Koren Publicationsʼ brochure: Bed-wetting and Chiropractic: Rosenfeld, J. & Jerkins, G.R. The bed-wetting child. Post Grad Med, 1991, 89, pp. 63-70. Lynch, D. Nocturnal enuresis: an evaluation and management with an illustrated case. J Osteopath Med, 1991, June 10-9. Young, D.E. & Young, R.R. Nocturnal enuresis: A review of treatment approaches. Am Fam Physician, 1985, 31, pp. 141-44. Spitzer RL, Chairperson. Diagnostic and statistical manual of mental disorders. 3rd ed. American Psychiatric Association Task Force on Nomenclature and Statistics, Phila., 1980. Forsythe, W.I. & Redmond, A. Enuresis and spontaneous cure rate: study of 1129 enuretics. Arch Dis Child, 1974, 49, pp. 259-63. Bachman, T.R. & Lantz, C.A. Management of pediatric asthma and enuresis with probable traumatic etiology. Proceedings of the National Conference on Chiropractic and Pediatrics (ICA), 1991, pp. 14-22. Blomerth, P.R. Functional nocturnal enuresis. JMPT, 1994, 17 (9), pp. 335-338. Gemmell, H.A. & Jacobson, B.H. Chiropractic management of enuresis: Time-series descriptive design. JMPT, 1989, 12(5), pp. 386-389. Reed, R.R., Scott, B., Reddy, S.K., & Kern, G. Chiropractic management of primary nocturnal enuresis. JMPT, 1994, 17(9), pp. 596-600. LeBoeuf, C., Brown, P., Herman, A. et al. Chiropractic care of children with nocturnal enuresis: A prospective outcome study. JMPT, 1991, 14 (2), pp. 110-115. San Francisco Chronicles, March 5, 1992. Moser, R. Bed-wetting: The wee hours of the night. Medical SelfCare, Jan/Feb 1990, p. 21. Nocturnal Enuresis by Claudia Anrig, DC Two Cases ..What I enjoy the most when the boys come in for their adjustments is being aware that their quality of life has improved. ... Chiropractic Management of Enuresis by Peter Fysh, DC ...The conclusion would therefore appear to be to have all children who are bed-wetters evaluated for the possibility of spinal problems as the underlying cause...

Peer Reviewed Publications:

1) Chiropractic management of primary nocturnal enuresis. Reed WR, Beavers S, Reddy SK, Kern G. JMPT Vol. 17, No. 9 Nov/Dec 1994. This was a controlled clinical trial of 46 enuretic children that were placed under chiropractic care. The children were under care for a 10 week period preceded by and followed by a 2 week nontreatment period. Participants: Forty-six nocturnal enuretic children (31 treatment and 15 control group), from a group of 57 children initially included in the study, participated in the trial. Results:...25% 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.

2) Nocturnal enuresis: treatment implication for the chiropractor. Kreitz, B.G. Aker, P.D., JMPT 1994:17(7): 465-473. A review of the literature of nocturnal enuresis is presented. The author states: “Spinal manipulative therapy has been shown to possess an efficacy comparable to the natural history.”

3) Chiropractic care of children with nocturnal enuresis: a prospective outcome study. LeBouf C, Brown P, Herman A et al. JMPT, 1991;14(2):110-115. 171 Children with a history of persistent bed-wetting at night received eight chiropractic adjustments. Number of wet nights fell from 7/week to 4. At the end of the study, 25% of the children were classified as successes.

4) Functional nocturnal enuresis. Blomerth PR. JMPT 1994:17:335-338. Eight-year-old male bed wetter. Lumbar spine was manipulated once and at 1 month follow-up there was complete resolution of enuresis. “This happened in a manner that could not be attributed to time or placebo effect.”

5) Neurogenic Bladder and spinal bifida occulta: a case report. Borregard PE. JMPT 1987; 10(3):122-3. Examination found fixation in L3 and both SI joints, following the restoration of SI function the patientʼs mother reported the patient was now aware of bladder distention approximately 30 minutes before it was necessary to void. A slight of bladder sensitivity occurred 4 months after the release from treatment and responded immediately to manipulation.

6) Chiropractic care of children with nocturnal enuresis: A prospective outcome study. LeBoeuf, C.; Brown, P; Herman, A; Leembruggen K; Walton D; Crisp TC. JMPT, 1991, 14 (2), pp. 110-115. In 171 children suffering from 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.

7) Chiropractic management of enuresis: time series descriptive design. Gemmell HA, Jacobson, BH JMPT 1989; 12:386-389. Case of a 14-year-old male with a long history of continuous bed-wetting that was alleviated (not completely cured) by adjustments.

8) Characteristics of 217 children attending a chiropractic college teaching clinic. Nyiendo J. Olsen E. JMPT, 1988; 11(2):78084. The authors found that pediatric patients at Western States Chiropractic College public clinic commonly had ordinary complaints of ear-infection, sinus problems, allergy, bedwetting, respiratory problems, and gastro-intestinal problems. Complete or substantial improvement had been noted in 61.6% of pediatric patients of their chief complaint, 60.6% received “maximum” level of improvement while only 56.7% of adult patients received “maximum” level of improvement.

9) Epileptic seizures, Nocturnal enuresis, ADD. Langley C. Chiropractic Pediatrics Vol 1 No. 1, April, 1994. This is an eight year old female with a history of epilepsy, heart murmur, hypoglycemia, nocturnal enuresis and attention deficit disorder. The child had been to five pediatricians, three neurologists, six psychiatrists and ten hospitalizations and had been on Depakote, Depakene, Tofranil and Tegretol. Birth was difficult including a cesarean under general anesthesia. Mother was told the baby was allergic to breast milk and formulas and stayed on prescription feeding. The doctors told the mother the girl would never ride a bike or do things like normal children do. The child was wetting the bed every night and experiencing 10-12 seizures/day, with frequent mood swings, stomach pains, diarrhea and special education classes for learning disabilities. Chiropractic adjustments: C1 and C2 approximately three times/week. After two weeks of care the bed-wetting began to resolve and was completely resolved after six months. She was also leaving special education classes to enter regular fifth grade classes. Seizures were much milder and diminished to 8-10 per week after one year of care. Patient was also released from psychiatric care as “self managing.” Her resistance to disease in-creased and she can now ride a bike, roller skate and ice skate like a normal child. After medical examinations, she is expected to be off all medication within a month.

Case Studies:

1) Bed-wetting; two case studies. Marko, RB Chiropractic Pediatrics Vol. 1 No. 1 April 1994. Case #0991: Five year old female who had been wetting her bed for six months. She was prescribed antibiotics for what MDs diagnosed as a bladder infection. After the second chiropractic adjustment, she stopped wetting her bed for three weeks. She had a bad fall and began to wet her bed again. After her next adjustment, she has remained dry. Case #0419: Nine year old male who wet his bed almost every day of his life. After the first six months of chiropractic, he would be dry for the next day or two. A change in adjustments to the sacrum resulted in greater improvement. He is now dry for one-half to two-thirds of the nights between the adjustments.

2) ADD, Enuresis, Toe Walking. International Chiropractic Pediatric Association Newsletter May/June 1997. From the records of Rejeana Crystal, D.C., Hendersonville, TN. A six year old boy with nightly nocturnal enuresis (bedwetting), attention deficit disorder and toe walking. He walked with his heels 4 inches above the ground. The medical specialist recommended that both Achillesʼ tendons be cut and both ankles be broken to achieve normal posture and gait. Chiropractic findings included subluxation of atlas, occiput, sacrum and pelvis…after 4 weeks of care both heels dropped 2 inches and the bedwetting frequency decreased to 2-3 times per week. His doctor could not believe how chiropractic care made such a change.

3) Management of pediatric asthma and enuresis with probable traumatic etiology. Bachman TR, Lantz CA Proceedings of the National Conference on Chiropractic and Pediatrics (ICA), 1991: 14-22. A 34-month-old boy with asthma and enuresis had not responded to medical care. More than 20 emergency hospital visits had taken place for the asthma attacks during a 12 month history. Three chiropractic adjustments were administered over an 11 day period and the asthma symptoms and enuresis ceased for more than 8 weeks. The asthma and enuresis reoccurred following a minor fall from a step ladder but disappeared after adjustments. After a two year follow-up, the mother reports no reoccurrence of the asthma or the enuresis. Additional Articles: Chiropractic management of primary nocturnal enuretic children. Reed WR; Beavers S; Reddy SK; Kern G; Proceedings of the National Conference on Chiropractic & Pediatrics. 1993 Oct. pp 64-82. There were 46 primary enuretic children over a period of 14 weeks to assist in evaluating the influence of chiropractic care. Subjects were between 5 and 13 years of age. The 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. The children receiving chiropractic care averaged a 17.9% reduction in wet nights over the control group over the same period of time. Visit: : http://www.chiroweb.com/archives/17/04/04.html for an article on nocturnal enuresis References from Koren Publicationsʼ brochure: Bed-wetting and Chiropractic: Rosenfeld, J. & Jerkins, G.R. The bed-wetting child. Post Grad Med, 1991, 89, pp. 63-70. Lynch, D. Nocturnal enuresis: an evaluation and management with an illustrated case. J Osteopath Med, 1991, June 10-9. Young, D.E. & Young, R.R. Nocturnal enuresis: A review of treatment approaches. Am Fam Physician, 1985, 31, pp. 141-44. Spitzer RL, Chairperson. Diagnostic and statistical manual of mental disorders. 3rd ed. American Psychiatric Association Task Force on Nomenclature and Statistics, Phila., 1980. Forsythe, W.I. & Redmond, A. Enuresis and spontaneous cure rate: study of 1129 enuretics. Arch Dis Child, 1974, 49, pp. 259-63. Bachman, T.R. & Lantz, C.A. Management of pediatric asthma and enuresis with probable traumatic etiology. Proceedings of the National Conference on Chiropractic and Pediatrics (ICA), 1991, pp. 14-22. Blomerth, P.R. Functional nocturnal enuresis. JMPT, 1994, 17 (9), pp. 335-338. Gemmell, H.A. & Jacobson, B.H. Chiropractic management of enuresis: Time-series descriptive design. JMPT, 1989, 12(5), pp. 386-389. Reed, R.R., Scott, B., Reddy, S.K., & Kern, G. Chiropractic management of primary nocturnal enuresis. JMPT, 1994, 17(9), pp. 596-600. LeBoeuf, C., Brown, P., Herman, A. et al. Chiropractic care of children with nocturnal enuresis: A prospective outcome study. JMPT, 1991, 14 (2), pp. 110-115. San Francisco Chronicles, March 5, 1992. Moser, R. Bed-wetting: The wee hours of the night. Medical SelfCare, Jan/Feb 1990, p. 21. Nocturnal Enuresis by Claudia Anrig, DC Two Cases ..What I enjoy the most when the boys come in for their adjustments is being aware that their quality of life has improved. ... Chiropractic Management of Enuresis by Peter Fysh, DC ...The conclusion would therefore appear to be to have all children who are bed-wetters evaluated for the possibility of spinal problems as the underlying cause...