July 15, 2012,
L.O. asks from Haverhill, MA on May 14, 2008
Child with Constant Need to Urinate - Any Experience?
My soon-to-be 6 year old daughter is having major problems, and I wonder if anyone out there has had a similar experience. It has her pediatrician puzzled. She has signs similar to a urinary tract infection or a vaginal strep - constant urge to urinate every 5 minutes. Usually nothing comes out when she runs urgently to the toilet. Both the urine culture and strep cultures have come back negative. In addition she has very loose b.m.'s - bordering on diarrhea, but not quite. Her bottom is quite red (and the pediatrician witnessed it, saying "No wonder she needs to pee so often. The irritation is causing the urge.") She had all these same symptoms starting in the beginning of March - all same tests, including bloodwork, came back negative. Symptoms subsided but didn't go away completely, at the end of the month - had my other daughter in for an ear infection, doctor noticed a rash and suspected her of having strep - tested both kids, and this time my 6-year-old tested positive. They gave her antibiotic, and it cured the urination problem. Problem is now back again, once again she tests negative, and I have nowhere to go with this problem. Has anyone else ever had their child test negative for strep, but turn out in the end to be a "false negative" and they really DID have strep (vaginal strep in our case)? Or is there some other possibility we are all overlooking? This has REALLY caused a problem in our lives. We can go nowhere, since she feels this urgent need and will not wear a pull-up or a pad. She really suffers, because she'll ask "Mom, did I just go to the bathroom? Should I try to hold it, or should I go?" Poor thing. I feel like we need antibiotics, since it seemed to cure it last time, but our pediatrician will not give without a positive test. Any thoughts?
Hi - after receiving some very thoughtful responses, thought I'd just give this little update. Three years ago my older daughter suffered with constantly reoccuring urinary tract infections. (These actually tested positive in the cultures). Her pedi sent us to a pediatric urologist in Boston. After a year of visits, multiples tests - we were nowhere. Finally at a regular doctor visit, when she happened to be also having urinary problems again - I begged him, please didn't HE have maybe some thoughts, because this "specialist" was nice, but getting us nowhere. Our pedi finally came up with the answer - and she has been cured ever since. So I truly think our pedi knows way more than a urologist. In the meantime, he just 5 minutes ago told me he'll try her on an antibiotic for 3 weeks - so I'll keep you posted. But still would like to hear from anyone who has had a similar experience and might know what is going on. Thanks to you all - your support means a lot.
So What Happened?™
Thanks to ALL the kind mothers who took time out of your busy day to respond to me! So much knowledge! In the end, her pediatrician said let's try a three week course of antibiotics. Within a day there was some immediate relief - not complete, but she could wait about an hour, rather than just 5 minutes. By the end of the 3 week course, she was about 2 hours, and by a week later she was cured. Don't know if the antibiotics cured it or not, but she had other strep-type symptoms that it definitely cured. We may never know what really was causing the urinary problems. I'm keeping my fingers crossed that it never comes back!
K.W. answers from Boston on May 15, 2008
I know this may sound strange, but have you ever considered taking her to a pediatric chiropractor? I'm wondering if there might be a misalignment in her neck/spine that's not allowing her body to function correctly. There's a great one in Amherst,NH called Spinal Corrective Center - they're great with kids...the doctors are married with 2 small children themselves. They've done amazing things to help people/kids when other doctors were stumped...actually, they help the body help itself. Hope this doesn't sound too weird! Good luck - I know this must be hard for you...and for her!!! :)
K.T. answers from Boston on May 14, 2008
I am so sorry to hear this. Sometimes the constant urge to urinate, and nothing comes out could also be a kidney stone. But after reading your story and all she has been through, I would consult with a pediatric urologist and get to the bottom of her problem. I would also tell them this is urgent and you cant wait long for a appointment.
Best of Luck, and I'd be interested in knowing what happens if you want to share.
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J.A. answers from Boston on May 15, 2008
Well, UTI is the most obvious answer, but have you also had a specimen of stool sent for culture and ova and parasites? I would recommend having the stool checked.
Another possibility could be a systemic yeast infection. If that is so, antibiotics would only make it worse. A systemic yeast infection would be treated with Diflucan an oral drug.
You could try adding yogurt to her diet regularly (about twice per day) Just don't buy the sugary kids "yogurt" you need one with active cultures and no or very limited added sugar.
Another diet supplement would be cranberry. Cranberry juice cocktail is full of sugar and will worsen yeast, however cranberry extract can be found in a concentrated supplement form. Any health food store or Whole Foods would carry it.
Could she be lactose intolerant? Sometimes "watery stools" are caused by lactose intolerance which in turn leads to more cross contamination of her urinary tract. You could try eliminating milk from her diet use Lactaid instead and see how she reacts. My daughter who is lactose intolerant at first did not like the lactaid so I added chocolate sauce. Now she hates the taste of regular milk and only wants her Lactaid. (even without the chocolate sauce) My daughter, like many others who have lactose intolerance, can eat cheese it is only milk which causes her symptoms.
Additionally, keep her well hydrated to decrease the acidity of her urine. Consider using a "peri-bottle" to rinse her peri area when possible after urinating. Also monitoring her wiping after BM to be sure she is wiping front to back and meticulous with her cleaning. Residual stool can be very irritating to the skin and can lead to UTI when tracked into the genital area. A light skim of A and D ointment applied to the rectal area and genital area can be protective and soothing. (obiviously, apply to genital area first then rectum to avoid cross contamination)
Additionally, when she does void, make sure she is pushing her pants all the way down to the ankles and opens her legs slightly to allow the urine to flow quickly away from the body. And I'm sure the pediatrician has already told you avoid bubble baths.
Assuming your daughter has already had a full bladder workup including looking for urinary reflux and urine retention; I would also remind your daughter not to hold her urine too long as she will enlarge her bladder and make it less effective at emptying.
Once she does urinate. If she states she has to urinate again 5 minutes later ask her to wait. She is probably feeling a little spasm and straining to urinate further will only cause more spasm. Assure her the feeling should go away in a short while.
You could also try delving a little into her psyche. Sometimes with small children little worries which they keep to themselves can balloon into obsessive thoughts which could be alleviated if they share them with others. My six year old who had similar symptoms was really just obsessed with having an "accident" so she just kept going and going until she was having symptoms of UTI secondary to the straining.
Sorry I went on and on, but as you can probably tell we've been through a similar situation. I hope these suggestions are helpful.
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S.T. answers from Los Angeles on May 03, 2010
Hellllppp! I am having the same problem with my four year old- constant urge to urinate, nothing comes out, and negative test results for any bacteria. Pediatrician says it's a "mental" thing but my gut instinct tells me otherwise. I feel sooo helpless!
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R.F. answers from Boston on May 15, 2008
Since your daughter has been on lots of antibiotics have you thought about the possibility that she might have candida? It could be intestinal rather than vaginal and cause all of the symptoms you have mentioned. I myself have been battling candida for quite some time now and think I am (hopefully) on the winning end of the battle. There is lots of information on the web about it if you google it. Here's a short version of what you can do to help get rid of it....
Start her on probiotics. You can get childrens formulas at your local healthfood store or have them special order them for you. Have her eat lots of yogurt, or drink kefir as they both have strains of probiotics in their cultures.
Next eliminate wheat, sugar and dairy (except for the yogurt or kefir) from her diet. That includes all sweet fruits (bananas, apples, etc.) except for lemons and grapefruit. Do this for about 3 weeks to see if her symptoms lessen then slowly introduce these back into her diet. Give each food about a week and watch to see if symptoms return. Wheat and dairy allergies can cause these same symptoms so this will also be a great way to find out if that's the problem.
Make sure that she gets lots of fiber from other sources to help sweep the bacteria out of her intestinal tract. Try getting her to eat oatmeal for breakfast, maybe sneaking some ground flax seed into her yogurt and rice and other whole grains at dinner.
Candida is a bacteria that lives in all of our bodies but when it's allowed to over grow it can be really bad for us. Antibiotics and sugary diets allow this to happen. I have found during my research that candida is responsible for a host of other seemingly unrelated symptoms and that most people suffer from candida over growth and don't even know it. Please feel free to email me directly if you have any other questions. Good luck! I know it's frustrating to have a sick child and not be able to figure it out.
A.R. answers from Boston on May 17, 2008
I am not even close to being a Mom with a medical degree! Many times I could have wished for just that myself :D
Have you thought of bringing your daughter to a pediatric gastroenterologist? The reason I mention this is there is a genetic condition that is very underdiagnosed in this country called Celiac... it sounds much worse than what it is. It is basically the bodies inability to process gluten found in wheat, rye and barley and it causes a number of very strange symptoms. One of the more common being frequent to constant diahreia (sorry for spelling errrors). Many Dr.s are uneducated or undereducated on this particular type of problem and unless the individual shows very textbook classic symptems it can go undiagnosed for years.
I am one who did not have the classic signs, I had stomach problems for years but not the diahrea. One of my nieces had years of urinary tract problems and another niece broke out in unexplainable skin rashes. None of us had the classic symptoms yet it turned out that we all had the same genetic condition.... Celiac, just presenting itself in many of the numberous ways that it can. In each case once we went onto a gluten free diet which does require a period of time for your body to heal we all ended up with our problems clearing up. No more rashes, stomach problems, urinary tract problems etc...
I do not want to get your hopes up and say this is the solution to your daughters problem but it might be one avenue that is worth exploring.
Hope all works out well for you and your daughter.
I.J. answers from San Francisco on July 15, 2012
We are going through this exact same situation right now with my almost 6 year old. What was the final diagnosis causing these problems for your daughter? And in the end, was it the anti-biotics that was the cure?
L.S. answers from New London on May 14, 2008
Why hasn't your pediatrician sent you to a specialist yet? Like a urologist?? She needs to see one ASAP. Pediatricians don't know everything! Watch what she eats as well. This could be a food allergy (especially since her botton is so red).
X.D. answers from Boston on May 15, 2008
I am very interested in what you find out as my daughter has been having similar problems. I assumed that she was nervous..... have an older daugher who used the bathroom as an excuse sometimes. Good-luck!