Bed-wetting

• Introduction
• Research
• TCM Clinical Trials
• Patient Form

Introduction

Enuresis or ‘bed wetting’ is a childhood medical condition that is successfully treated by Traditional Chinese Medicine. In fact, enuresis is one of the most frequently addressed problems by paediatric specialists of TCM today. Most children achieve night-time dryness by the age of four or five, but it is estimated that 20% of five-year-olds experience enuresis. In addition, 3% of 12-year-olds and 1% of people 15+ year olds continue to suffer from bed-wetting. So what are the majority of parents doing about this? Nothing. Research shows that only 38% of parents seek medical assistance for their children. Unfortunately, doing nothing is the worst thing a parent can do when dealing with their child’s enuresis because the child only has a 15% chance of “growing out” of their problem by their next birthday.

Despite numerous studies on primary nocturnal enuresis, the cause of bed-wetting remains elusive to modern medicine (with only 1-3% of cases having an identifiable cause). On the other hand, TCM has established what causes bed-wetting and over the last two millennium, developed many effective treatments for this disease.

Research shows that Traditional Chinese Medicine is a vauable treatment for children who experience enuresis. In comparison studies, TCM has consistently proven to be more effective than modern medications yet avoids the side effects that are commonly experienced with the modern medical approach. In TCM, all forms of treatment including tuina, acupuncture, Chinese medicinals (external or internal), and dietary therapy are effective in treating enuresis.

TCM’s tried and true secret to enuresis success is that each and every treatment is tailored towards meeting the unique needs of the patient. This ancient medicine channels its energy in the direction of treating the causes of a disease instead of just managing the symptoms.

Robert Helmer’s current book, “The Treatment of Pediatric Enuresis with Acupuncture and Chinese Medicine” by Blue Poppy Press, contains over 150 TCM treatments proven to be effective in medical studies for treating enuresis in children. By treating the ‘root’ of this socially taboo disease, TCM can cure enuresis and also prevent future diseases that are related to the same disease mechanism. Children who experience bed-wetting deserve relief from their suffering and with the right treatment, their condition will improve within a matter of days or weeks.

Success Story

Nighttime's silent shame
Kids and parents hate to talk about the condition that means disrupted sleep, soaked sheets, extra laundry

By Carmelina Prete, The Hamilton Spectator (Jan 13, 2006) (abstracted)

“A good night's sleep was a rarity in the Worley household. For years, Sharlene Worley would wait until about midnight to wake both her sons and take them to the washroom. Then, she'd usually get up twice more during the night to change their sheets. Sometimes her husband traded duties. Her sons were both deep sleepers and chronic bedwetters. One is nine. The other is 12. This had been the family's night routine for years. "I don't sleep very well, not since they've been born," she says. "It's all so very frustrating." The Burlington mother doesn't want her real name used. Like many parents, she doesn't want people to know about her sons' condition lest they be teased.”

”DDAVP is often recommended for special occasions, such as camp or a sleepover. The Worley boys had used medication (DDAVP) but a synthetic hormone is not something their mom wanted to give them often. Then, in July, they turned to a local practitioner of Traditional Chinese Medicine (TCM) who specialized in treatment of children.”

“TCM worked for the Worley boys. The youngest stopped seeing the TCM paediatrician in September -- less than three months after his first visit. He has wet his bed only three times since July, which both the doctor and Worley attributed to drinking too much right before bed. The eldest still sees TCM doctor but his situation has also improved dramatically. He used to wet the bed two or three times a night. Now, it averages less than once a week. He uses both TCM and the moisture alarm. His mom says life is better now. "I'd like it all to go away. But when I compare it to where we were in July, it's a big improvement." She adds: "I sleep better now."


Research

• Bedwetting and Baby Food
• Physical and Emotional Impact of Schoolyard Bullies

Bedwetting and Baby Food

Early childhood nutrition is fundamental to how the brain and nervous system develop. An intriguing July 2006 study from the Robert Wood Johnson Medical Center, published in Pediatrics, showed among other things, that babies who got adequate DHA in the first year of life were about 80 percent less likely than their peers to wet the bed. Moreover, in the study in question, the biggest differences were found depending on how children were fed in the first 3 months of life. Children who were breastfed for at least 3 months were dramatically less likely to become bedwetters than those who depended on infant formula without added DHA. Nursing for longer periods of time, up through the first year, continued to offer significant protection from the likelihood of bedwetting. The authors speculate reasonably that the difference in bed wetting may have been due to the differences in neurodevelopment arising from differences in DHA levels. When considering the results of this study, it is important to remember the physical and psychological differences between breast and bottle feeding may have also had an effect on the study results.

Physical and Emotional Impact of Schoolyard Bullies

Bullying whether psychological or physical ranges from teasing to physical attacks. The August 1999 edition of the British Medical Journal published two studies about the health effects of bullying on children in Finland and Australia. The journal reported that abdominal pain, headaches, bedwetting, sleep problems, anxiety, insecurity, and depression were all much more common both in children who considered themselves bullies or victims. The rates were highest in those kids who felt that they were bullied and in turn bullied others. Regular complaints of these physical symptoms my be clear indicators that we need to listen to our kids and find out what is happening on the playground.


TCM Clinical Trials

Study 1

The observations of using Chinese herbal medicine to treat pediatric enuresis first appeared in the journal of New Chinese Medicine (#12, 2002). The 96 cases in this study were divided into two groups – treatment group and comparison group. The treatment group used the herbal formula, Yi Niao Ling Fang (Effective Enuresis Formula) and included 50 cases. This formula was composed of twelve different Chinese herbs. Modifications were made to this formula based on the patient’s clinical presentation. The comparison group included 46 cases and they were administered impramine hydrochloride. In both groups, eight days equaled one course of treatment. There was no significant difference between the two groups prior to treatment. In both groups, the cases were between the ages of 5-13 years old, and the patients had enuresis 1-4 times per night.

Results

Type	Cure Group	Improvement	No Improvement	Amelioration Rate
Treatment	42 (84%)	7 (14%)	1 (2%)	98.00%
Comparison	22 (47.83%)	12 (26.09%)	12 (26.09%)	73.91%

Statistically there was significant difference between the treatment group and comparison group amelioration rates. In those cases that were cured, the course of treatment in the treatment group was 4-21 days, with and average of 9 days, and the course of treatment of the comparison group was 10-32 days, with a median of 18 days. These cases also demonstrated a significant difference compared to the comparison group.

Follow-up visits (6 months, 1 year and 2 years) on cases that were cured showed a resumption of bed-wetting in 54% of patients in the comparison group and only 9.5% in the treatment group. Four cases in the comparison group had side effects of dizziness and dry mouth that disappeared with a decrease in dosage.

Study 2

In recent years, Dr. Zhao Ling employed his teachers, head doctor Lu Chang-qing’s, empirical formula to treat 30 cases of pediatric enuresis. This treatment brought forth satisfactory results and a summary of the results of this doctor’s findings were published in the Sichuan Journal of Chinese Medicine (#8, 2002). Yi Qi Suo Niao Yin (Boost the Qi & Reduce Urine Beverage) was the name of the formula used in this study and this formula was composed of 15 different Chinese herbs. The age of the child was observed in order to establish the proper dosage. The formula was modified by adding and substracting ingredients based on the patient’s clinical presentation. Seven days equaled one course of treatment. In 15 cases, symptoms disappeared after one course of treatment, and in 10 cases, the symptoms disappeared after two courses of treatment. An obvious decrease in frequency of enuresis was observed in five cases. Follow-up visits after one year showed no recurrence in 20 cases.

Study 3

The Chinese authors of this study were invited to work in Russia at an international medical treatment center from 1991-1992. During this time, they treated 78 cases of pediatric enuresis using Tuina (i.e. Chinese massage). A summary of these results appeared in the Guangming Journal of Chinese Medicine (#4, 1995). The children ranged in age from 4-18 years old. All 78 cases had had enuresis since infancy. Seven cases had enuresis three or more times per night, 66 cases had enuresis 1-2 times per night, and five cases had enuresis every other night. The acupuncture points massaged in this protocol consisted of: Zhong Wan (CV12), Qi Hai (CV 6), Guan Yuan (CV 4), Zhong Ji (CV 3), Zu San Li (St 36), San Yin Jiao (Sp 6), Bai Hui (GV 20), Ming Men (GV 4), Pang Guang Shu (Bl 28), and Ba Liao (Bl 31-34). Each point was massaged for 1-2 minutes. Additional points and manipulation methods were based on the individual clinical presentation. Each day, the child was treated one time, and each time the manipulation lasted 20-30 minutes. Seven consecutive days equaled one course of treatment. After 1-3 courses of treatment, 65 cases (83.33%) were cured, 12 cases (15.38%) had marked improvement, and one case did not improve. In this case, the child suffered from pyelonephritis.


Patient Form

This printable handout is to inform current patients how they can assist in the healing process by offering helpful tips and suggestions.