Wednesday, May 23, 2012

Medical Problem or All in His Mind?

My son has been asking to use the bathroom to pee quite frequently lately. Sometimes he will pee four times in a less than an hour. A couple weeks ago, we had him checked out by his pediatrician.

The doctor took a urine culture and examined him. He said that there was no physical problem with Kai. In his opinion, this is a behavior issue.

I wondered if he would have come to the same conclusion if he had not known that Kai has autism.

Not that I necessarily disagree.

One of the challenges of having a child with autism is deciphering symptoms and trying to figure out if there is a medical problem.

For instance, Kai will frequently say that his stomach hurts, but often we will think that it is his way of trying to get out of an activity he does not want to do, or to keep from eating something he doesn’t want to eat.

In similar ways, he will complain that his leg hurts or his back hurts or something similar. How are we to know for sure whether or not he is really feeling any pain?

With this latest issue with the frequent bathroom visits, we do not see a pattern of him trying to avoid activities. He just seems to really have to go. Sometimes, he will go to pee only a few minutes after he just did. But his need to urinate does not seem to be only in his mind; even when he goes again so soon, he does pee a fair amount most of the time.

We discussed our latest quandary about the frequent bathroom visits with his therapist at school. Kai had been asking to use the bathroom quite frequently there as well.

Since the doctor ruled out a medical problem, the therapist and staff at school decided to treat this as a behavioral issue. They said that this behavior is not uncommon, particularly with boys.

They told Kai that he would be allowed to use the bathroom once every other period. They set up a visual schedule for him, but he became very anxious about having to hold it for so long. After a day or two, the school eased the schedule to permit one visit every period.

Earlier this week, Kai went to the bathroom four times during a 45-minute session with his speech therapist. At one point, he looked extremely uncomfortable and said that he was in pain. And then, even though he used the bathroom right before leaving, he could not hold it and wet his pants in the car on the drive home.

So now we have made an appointment with a specialist.

There is a part of us that hopes the doctor finds a medical problem. That way we would know what is going on and, hopefully, be able to treat it.

If this doctor finds that nothing is physically wrong with Kai, we will have to find ways to change his bathroom habits. And that will not be easy.


  1. Oh, that is frustrating. At first I thought it was an obsessive thing, but with the pants wetting, it seems obvious that there is something else going on. I hope it's an easy fix, too! It sounds like an infection, doesn't it..but the doctor would have seen that with a urine test. Hmmm.

    1. Betsy, I was thinking the same thing... but when Kai wet his pants, that cinched it for me to see a urologist. Though it could be more of a neurological issue like Shiroi mentions below.

  2. All the doctor did was check for infection or trauma. It was neurological with me. My urinary signaling system was askew until I was in my early teens. I had the opposite problem...I hadn't received signals strong enough to let me know I had to go...until it was almost too late. I also wet the bed until my early teens because of this. My signals were reset using a nighttime moisture alarm. In a very short period of mind recognized the call.

    Anything change in his diet recently...anything that could act as a diuretic? Often times...a day or so after I had eaten especially salty foods...I have to get rid of a lot of retained water also.

    If he has to go shortly after peeing...he is not fully voiding his bladder. It had happened to me sometimes when I was his age. My nervous system wasn't fully coordinated. I still couldn't run straight at his age (I kept going in circles) leg was faster than the other.

    I feel for Kai. I had sometimes felt betrayed by my body. When I got into sports...I saw it as a means to master my body. That was when all of my neurological problems went away. With me...long and hard endurance training corrected everything.

    Also, with me (at Kai's age) was never something I had wished to happen to me...and I was certainly never in control of it.

    1. Shiroi, we used a nighttime moisture alarm when doing night-time potty training, and it was very effective. This latest issue of peeing in his pants because he could not hold it is a first-time occurrence.

      I don't think his diet is having an effect, though we are experimenting with one of his medications to see if cutting back on it will reduce his need to pee so often.

      Thanks for sharing your experience. I think that, like with you, Kai does not have control over this and it does not make him feel good. Hopefully we can find a way to get him back on track.

  3. Interesting... any diheruetics in his meds? or med changes? I think you are right, doctors are quick to say "it's an autism thing" even if it may not be. You're the dad, go with your gut Yuji! You know Kai way better than any doctor.

    1. Molly, we thought it was possible that it was med related with something Kai started on most recently. We stopped it for several days, and now have started to slowly introduce it again to see what effect, if any, it is having. But, we can't yet tell for sure if that is the cause.

      Your point about parents knowing their child better than the doctor is a good one.


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