Secondary Bed Wetting; What Do I Do?

By definition, secondary bed wetting means that the nighttime bed wetting reappears months or years after the child has become night dry. There are a lot of common and harmless causes for this.

• Increased amount of emotional stress like starting a new school, birth of a new sibling, conflict at home between parents, or moving to a new home can be stressful for a child
• Some kids are very deep sleepers and might not recognize the urges to go
• Urinary tract infections can be asymptomatic and sometimes the only symptom is frequent urination and bed-wetting
• Constipation can be a great contributor, especially for females
• Type 1 diabetes onset is in early childhood and common symptoms for that include excessive thirst leading to frequent urination. Type 1 diabetes can also, if uncontrolled, do some damage to nerves and lead to dysfunction of the bladder

There are some neuroinflammatory causes for secondary bed wetting which can be overlooked by a lot of providers. Post-infectious autoimmune disorders like PANS and PANDAS are commonly causing issues with bladder control. Immune system targets part of the brain called basal ganglia which can affect behavior, mood and bladder control. These kids would experience other symptoms as well including OCD tics, anxiety, hallucinations, regression of learned skills and secondary bed wetting being very common.

Histamine overload is not often suspected by providers when it comes to bladder control. Most people think about common respiratory symptoms with histamines, i.e. watery eyes, sneezing, and runny nose during environmental allergy season. But histamine has a broad effect throughout the body. Histamines can irritate the bladder lining which can increase nighttime urination. Histamine overload can also lead to constipation which was earlier discussed as a contributor to nighttime bed wetting. There are several gut infections like candida, clostridium, and parasites which can produce neurotoxins which can cross the blood brain barrier. In these cases, we can see irritability or night terrors, sensory processing issues, poor sleep, and bladder signaling. Heavy metal toxicity and mold exposure leading to mycotoxins can irritate the bladder lining as well and increase urgency, frequency, and lead to secondary bed wetting.

If your child has been night dry for a long time and now started to have bed wetting issues, scheduling an appointment with the provider to find the root cause is important to address the underlying issue. Secondary bed wetting can be isolating for the child especially when they get older causing feelings of shame and avoiding social situations like sleepovers or visiting relatives.

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