RESEARCH

Case management of nocturnal enuresis Hough DW, Today’s Chiropractic July/August 2001 p. 59/66.

The author reports that usually two to three visits are required to solve bedwetting problems. He presents two case studies that are the extremes in number of adjustments.

1. Esta, a 4-year-old female, wet nearly every night. Subluxations were found at her sacrum, ileum, T3, T5 and cervical area. The next day her mother reported she was dry. She had no more problems with bedwetting from then on.

2. Aaron, a 5 year old male had pain in his feet in addition to nightly bedwetting. Subluxations were found in his sacrum, ileum, thoracic and cervical spine. In addition restrictions were found in the calcaneus vulgus of both feet.

Adjustments were performed. He no longer complained of foot pain and his mother reported that he was dry about half the nights since his previous visits. “Aaron required 10 more adjustments before his bedwetting totally resolved.”

Asthma and Enuresis. Zell, P. International Chiropractic Pediatric Assn. Newsletter May/June 1998

Case report #1374.

This is the case of a 7-year-old girl suffering from asthma and enuresis (bedwetting) brought to the chiropractor by her mother.

Since she was three years old she suffered from asthma along with many attacks of colds and flu. The asthma was so severe that she was hospitalized for 3 days at one time and had gone to the emergency room another time. The mother reports that her daughter would cough up a ball of phlegm following each attack.

Chiropractic examination revealed vertebral subluxation at C2, T5, T12 ileum and sacrum. She improved following her first adjustment. After the 5th adjustment the asthma and bedwetting ceased and did not return.

ADD, Enuresis, Toe Walking. International Chiropractic Pediatric Association Newsletter May/June 1997. From the records of Rejeana Crystal, D.C., Hendersonville, TN.

This is the case of a six-year-old boy suffering from nightly nocturnal enuresis (bedwetting), attention deficit disorder and toe walking. He walked with his heels 4 inches above the ground. The medical specialist recommended both Achilles’ tendons cut and both ankles 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 medical doctor was shocked at his recovery under chiropractic care.

Chiropractic management of primary nocturnal enuresis. Reed WR, Beavers S, Reddy SK, Kern G.J Manipulative Physiol Ther Vol. 17, No. 9 Nov/Dec 1994.

This was a controlled clinical trial of 46 enuretic (bedwetting) 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 no treatment period.

The 46 children were divided into two groups: 31 received chiropractic care and 15 were in the control group.

At the end of the study, 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.

Bed-wetting; two case studies. Marko, RB Chiropractic Pediatrics Vol 1 No 1 April 1994.

Case #0991.

This is the case of a five-year-old female who had been wetting her bed for six months and 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. Following her next adjustment, she has remained dry.

Case #0419.

This is the case of a nine-year-old male who wet his bed almost every day of his life. During his first six months of chiropractic care he would remain dry for one or two days after his adjustments. 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.

Functional nocturnal enuresis. Blomerth PR. Journal of Manipulative and Physiological Therapeutics 1994:17:335-338.

This is the case of an eight-year-old male bed-wetter. He was adjusted once in the lumbar spine. At a one month follow-up there was complete resolution of enuresis.

The child had two wet nights following a sports accident but was adjusted and the bed-wetting ceased. He had minor accidents one year and two years later, with enuresis starting again. In both instances the bedwetting ceased after adjustments.

The author remarks: “This happened in a manner that could not be attributed to time or placebo effect,” since the patient didn’t know that adjustments could affect that condition.”

Nocturnal enuresis: treatment implication for the chiropractor. Kreitz, BG, Aker PD. J Manipulative Physiol Ther 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.”

Epileptic seizures, nocturnal enuresis, ADD. Langley C. Chiropractic Pediatrics Vol 1 No. 1, April, 1994.

This is the case of an eight-year-old female with a history of epilepsy, heart murmur, hypoglycemia, nocturnal enuresis and attention deficit disorder.

The doctors told her mother that her daughter would never ride a bike or do things like normal children. She was wetting the bed every night, experiencing 10-12 seizures/day, with frequent mood swings, stomach pains and diarrhea. She was in special education classes for the learning disabled.

The child had been to five pediatricians, three neurologists and six psychiatrists. She had ten hospitalizations and had been on Depakote T, Depakene, T Tofranil T and Tegretol T.

Her birth was difficult (cesarean section under general anesthesia). Her mother was told the baby was allergic to breast milk and formulas and was on prescription feeding.

Chiropractic adjustments were to C1 and C2 three times/week. After two weeks of care, the bed-wetting began to resolve and was completely resolved after six months. During that period, her attention deficit disorder resolved and she left special education classes to enter regular fifth grade classes.

Her seizures diminished to 8-10 per week after one year of care. She was released from psychiatric care as “self managing.”

Her resistance to disease increased and she can now ride a bike, roller skate and ice skate like a normal child. She is expected to be off all medication within a month of this writing

Dear Abby. San Francisco Chronicle March 5th, 1992.

Although not a research study, this exchange of columnist “Dear Abby” addresses bed-wetting from a person-on-the-street perspective:

Dear Abby:

I took my 15-year-old twin sons (both daily bed-wetters) to a chiropractor, and within a month, both boys were completely cured. Regular medical doctors could not help them.” True Believer.

Dear True believer:

I believe you. I have several hundred letters bearing the same message concerning chiropractors

Chiropractic care of children with nocturnal enuresis: A prospective outcome study. LeBoeuf, C.; Brown, P; Herman, A; Leembruggen K; Walton D; Crisp TC. Journal of Manipulative and Physiological Therapeutics, 1991, 14 (2), pp. 110-115.

This is the study of 171 children with a history of persistent bed-wetting at night who received eight chiropractic adjustments each.

The average number of wet nights fell from 7 per week to 4 per week. At the end of the study, 25% of the children were classified as successes

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.

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.

This is the case of a 34-month-old boy with asthma and enuresis who had not responded to medical care.

He was brought to the hospital emergency room more than 20 times for his asthma attacks during a 12-month history.

The boy received three chiropractic adjustments over an 11 day period and the asthma symptoms and enuresis ceased for more than 8 weeks.

The asthma and enuresis recurred following a minor fall from a step ladder but disappeared after adjustments. After a two-year follow-up, the mother reports no recurrence of the asthma or the enuresis.

Enuresis, spasmodic dysmenorrhea and gastric discomfort: a vertebral subluxation complex entity. Regan KJ Dig Chiro Econ Mar/Apr 1990;32(5):110

This is a study of eight patients suffering from bed-wetting, menstrual cramps and ulcer pains/indigestion.

The patients had all been previously examined by MDs, had received pap tests, pelvic exams and upper GI studies and were negative for active pathology. One subject however did have a true peptic ulcer but wished to remain in the study.

The author writes: “A total of eight subjects in each category were selected and two in each category were not treated (to be used as control studies)..No one had any low back, dorsal or cervical spine pain prior to being a patient in this program.

Among those with menstrual problems, all cases of pelvic pain and severe cramping of the uterus had stopped. All women experienced three menstrual cycles through the duration of the study.

All the patients in the gastric category except one responded to chiropractic care; no one was taken off medication or put on special diet.”

Chiropractic management of enuresis: time series descriptive design. Gemmell HA, Jacobson, BH Journal of Manipulative and Physiological Therapeutics 1989; 12:386-389.

This is the case of a 14-year-old male with a long history of continuous bed-wetting. He never had a dry night in his life. The bell and pad method was tried but did not help.

Improvement began after the first adjustment. Over the next 21 days, he had 15 nights of dry bed and 6 damp nights, but not wet nights.

He continued to have dry, damp and wet nights. His condition was alleviated (not completely cured) by chiropractic adjustments.

Characteristics of 217 children attending a chiropractic college teaching clinic. Nyiendo J. Olsen E. Journal of Manipulative and Physiological Therapeutics, 1988; 11(2):78084.

The authors found that pediatric patients at Western States Chiropractic College public clinic commonly had complaints of ear-infection, sinus problems, allergy, bedwetting, respiratory problems, and gastro-intestinal problems.

Complete or substantial improvement of their chief complaint had been noted in 61.6% of pediatric patients, while 60.6% received “maximum” level of improvement. Only 56.7% of adult patients received “maximum” level of improvement.

Neurogenic Bladder and spinal bifida occulta: a case report. Borregard PE.J Manipulative Physiol Ther 1987; 10(3):122-3.

Examination found fixation in L3 and both SI joints, following the restoration of SI function the patient’s mother reported the patient was now aware of bladder distention approximately 30 minutes before it was necessary to void. A slight decrease of bladder sensitivity occurred 4 months after the release from treatment and responded immediately to manipulation.