7 year old and sudden bathroom issues

[Faithful_Steward]

I'm sorry, I wasn't sure if I should post this here, LC, or general. :)

 

I have a 7 y/o with adhd (hyperactive, impulsive). In the last few months he has started running to the bathroom every 10-15 minutes to pee. It is like he runs every time he feels the urge. He barely has anything to empty. He has always had issues with nighttime wetting but he has been daytime potty trained since he was 3. I had his doctor check for diabetes, UTI infection, and anything else that could cause these issues. The only thing that is unusual is that his thyroid levels are slightly out of range (not surprising because his sister and I both have them, and I have an extensive family history). His doctor is monitoring his thyroid right now but she doesn't think they are causing his bathroom issues. Her best guess is constipation, which doesn't actually seem to be a problem.

 

Seriously, it is getting ridiculous. He has OT for 45 minutes and goes to the bathroom 2-3 times while he is there. Yesterday I took him to the bathroom right before he went back and told him he was NOT ALLOWED to go to the bathroom while he is there. I told him he could go as soon as he was done. He still whined to the OT that he was going to pee his pants and ran off to the bathroom twice. He can go 4-5 hours between bathroom stops on road trips. His bladder is not full. And like I said, this issue has just started in the last few months.

 

So is this some sort of anxiety due to the nighttime wetting? Impulsivity? Rigidity? He has had a thorough evaluation. He has pretty intense ADHD and he's sensory seeking. He has dyslexia and dysgraphia. They ruled out anxiety and asd. He also briefly saw a behavioral therapist and she didn't identify any anxiety or other issues.

 

I'm hoping the HIVE has some insight.

 

[OneStepAtATime]

Hmmm....did they do any scans?  Could there be something pushing on his bladder?  One thing that happened when I was a kid was that I had a "spastic" bladder.  It would periodically spasm, making it feel like I HAD TO GO. I also developed some sort of air bubble that made there be much less room over all.  I was maybe 8.  

[PeterPan]

Has the OT been working on retained reflexes? Or did something in the therapy rub his lower back to set it off? Retained spinal galant causes wetting and can be set off easily. It will also flare up and get worse if they're working on integrating it. My ds' went off the charts, really off the charts.

 

For now, you need to let him go. Sounds like you're on top of the thyroid. I wouldn't assume constipation is not an issue. There's a whole book on it, I forget the title. The doctor behind the book came on here and gabbed a while once. It would be a really logical explanation.

[wapiti]

Urinary urgency issues of exactly the type you describe can also be a specific symptom of PANDAS.  Any possible exposure to strep lately?  Notice any slightly dilated pupils, insomnia, ocd/tics/separation anxiety?  Consider getting a swab for strep.  The sudden onset is an even bigger indication to look for strep since you have already ruled out UTI (to be clear, I am not suggesting strep infection in the bladder but a nervous system effect; I forgot the theory of the mechanism via the nervous system, but this urinary urgency symptom occurred in my house for both of my kids that had underlying sensory issues, and in both cases the urinary urgency issues were due to strep).

Edited April 6, 2017 by wapiti

[Faithful_Steward]

I can request a referral to a urologist to check for any specific bladder issues. Thanks.

 

The bathroom issue started before he started OT. She hasn't mentioned retained reflexes, but I can ask. The retained spinal galant "symptoms" seem pretty spot-on, but...ADHD. I did the quick test I found on one of the websites, but I probably did it wrong. :) I'll also start tracking his food/water/bowel movements to see if he is having issues there. It couldn't hurt.

 

Strep...that's interesting. I've never had a kid diagnosed with strep, but it is possible that he had it and just recovered without antibiotics. I'll talk to his doctor.

 

Thanks guys, you've given me a few more things to pursue. When I hit a dead-end with his pediatrician, I wasn't sure if it was more of a psychological issue.

Edited April 6, 2017 by Faithful_Steward

[PeterPan]

No, assume it's a physical problem, not just him being bad. 

 

You can google for the test for retained spinal galant, etc. Assume the OT is worthless on them, because most are. It's a shame, because it's a common issue. So do the tests yourself or, better yet, go ahead and just have him do the exercises anyway. I'm doing them myself now. I don't have time to have the PT test me for everything, so I'm doing them for x number now and will do the exercises for the other half of the pile in another month. Can't hurt. Any time ADHD is on the table, retained reflexes should be. Could be DRAMATIC.

[OneStepAtATime]

FWIW, there were times when I had strep as a kid that I did not run fever and only had a mild sore throat.  I didn't always share with my mom that I was feeling poorly so I may have had strep much more often than they realized.  Sometimes it got worse and one time I ended up in a wheel chair because it was affecting my muscles.  Other times I hardly looked or felt sick at all and without a test they would not have known I had strep.  Turned out my tonsils were permanently infected so I reinfected every few weeks.  Sharing this to say that sometimes you get a unicorn for a kid.  They may run asymptomatic for things like strep.

[Heathermomster]

With sensory issues and ADHD, there is a good chance that spinal gallant is affecting him.  The author of It's No Accident attributes many potty accidents to chronic constipation/impaction, and the only way to verify that is with an x-ray.  

 

Maybe, ensure he is having a BM everyday and take away all caffeine.  Ensure the SG is not an issue.  Read the book It's No Accident.

[Heathermomster]

I forget this.  Milk allergy can cause an issue too.

[Guest]

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Edited August 18, 2017 by Guest

[Guest]

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Edited August 18, 2017 by Guest

[kbutton]

Don't forget bladder irritants--the biggies are caffeine, tea, coffee, chocolate, cola (not just caffeinated), and CITRUS. Citrus would just about turn my bladder inside out, and it does my son as well. Food sources make a difference, not just drinks.

 

I would also wonder about allergies or intolerances.

 

I was told that it is actually possible to grow faster than your bladder (who knew)--obviously only a problem with a recent growth spurt. It resolves on its own.

[Guest]

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Edited August 18, 2017 by Guest

[HTRMom]

I also knew a child who peed constantly because she had a retained mass of stool in her bowel. She was having normal bowel movements every day, but she kept getting UTI's and peeing her pants because of this blockage. I think it was diagnosed externally but removed my colonoscopy, I'm not 100% certain on the treatment. I would definitely request a referral to a urologist.

[geodob]

This could be a result of anxiety about bed-wetting?

Judging how full our bladder is? 

Is an acquired skill.

The bladder has 'pressure receptors', that sense the increase in pressure as it fills.

But we have to learn how read the pressure, in relation to how full our bladder actually is.

 

Though his bed-wetting, could be making him anxious about the same happening when he is awake?

So that he has started reacting to any increase in pressure?

Just in case.

But going so early, all of the time. Will cause him to lose his ability to sense the increase in pressure, and recognise how full it actually is?

 

The way to resolve this, is when he says that he wants to go?  

Ask to wait 4 or 5 minutes. 

If he keeps doing this, the slightly increased pressure that occurs after 4 or 5 minutes?

Will become the new level that signals the urge to go.

Then this new level, can continually extended further and further.

 

Until he gains a real ability, to read how full his bladder, actually is.

 

I am familiar with this, through people that have lost this ability due to brain injury.

Where this 'waiting 4 or 5 minutes' is used to retrain their ability to sense how full their bladder really is.

 

[mom of 2 boys]

I do this sometimes, and I'm pretty sure it's OCD in my case. I will have an intrusive thought about it and get all anxious, then use the bathroom to relieve the anxiety. Just throwing it out there incase it helps you!

[sbgrace]

A friend's son has this in relation to OCD. 

Edited April 7, 2017 by sbgrace

[kbutton]

DH just mentioned last night that he was working with an older lady with dementia, and she has developed a sudden compulsion to need the bathroom all the time. They've ruled just about everything out, and they think it's a compulsion. So the OCD idea makes a lot of sense to me. 

[Faithful_Steward]

Thanks. The ocd thing makes sense to me, I just don't think that's what we're dealing with. And he's had SUCH thorough evaluations that I feel like someone somewhere would have noticed something. The anxiety about nighttime wetting makes a lot of sense, too. I appreciate the suggestions on how to "retrain" his bladder. I'm going to try that and also have his pediatrician dig deeper into possible physical causes. 

 

We have strep going through the house right now, but the bathroom issues obviously started before that. None of my kids have ever been tested for strep until now and his current pediatrician said they've likely all had it at some point and recovered without antibiotics. So the PANDAS and thyroid are both possibilities.

[kbutton]

I don't think wapiti said this directly, but PANDAS and OCD are linked. She almost said it, but in case that was unclear, I wanted to mention it. Other illnesses can cause the OCD as well, but PANDAS/strep is the one most recognized. As I understand it, kids who have PANDAS can be triggered by being exposed. If strep is going around, the exposure could have happened multiple times before your kids got it.

[Rosie_0801]

If he's taken a tumble recently, as kids do, it could be a chiropractic issue. The nerves to the bladder won't work properly if they are being squashed.

[wapiti]

The funny thing about the urinary urgency issues in the case of PANDAS is that there can be a nervous system component regarding bladder sensation (there may be a name for that but I forgot) as well as OCD regarding the issue, where the combination makes it trickier to sort out.  In my house, for one kid, we didn't realize it was all related but the urinary issue went away after strep was treated.  For another kid, the urinary issue also went away with antibiotics and even though there are other ocd issues leftover still, there is no major ocd issue for urinary urgency - it was primarily a sensation problem, not so much ocd.

 

OP, it may be well worth a swab.  (What I do:  buy them on amazon and then when they're positive or if I don't think I got a good swab, I go to the local urgent care.)

 

PANDAS aside, there is a school of thought that where there is a sudden onset of a neuropsychiatric symptom, rule out infectious causes.

Edited April 7, 2017 by wapiti

[Guest]

Faithful_Steward, :grouphug: while you are figuring things out. Hope you are all better soon.

[Faithful_Steward]

Thank you. :)