By Steve Hodges, M.D.
In my clinic, we x-ray all patients with enuresis (bedwetting or daytime wetting), to rule out the rare cases that are not caused by chronic constipation and to see just how much poop is clogging the child's rectum. An x-ray can be extremely helpful in guiding bedwetting treatment as well as treatment for daytime accidents.
In some cases, I also order x-rays to demonstrate to parents that their child is indeed constipated. Most folks have no idea, as the signs of constipation in children can be subtle and are not well-known, even among some physicians.
For example, everyone knows a child who poops once a week is constipated. But a kid who poops twice a day might also be harboring a lump of poop the size of a softball. Few adults realize that giant poops and hard logs are far more telling than pooping frequency.
What's more, pee and poop accidents are, themselves, signs of constipation. Many parents tell me, “My child wets the bed but has no signs of constipation.” That’s like saying, “My child can run a mile in 5 minutes but shows no signs of athleticism.”
While x-rays are the most accurate way to diagnose constipation in a child, in most cases, x-rays aren't necessary to start treatment. And in many countries, I realize, x-rays for constipation are not even available. For most kids, that's OK. If you know what you're looking for, you can detect constipation in your own child based on their symptoms.
I discuss these and other signs in depth in The M.O.P. Anthology: The Proven Way to STOP Bedwetting, Daytime Enuresis, Encopresis, and Chronic Constipation in Toddlers Through Teens.