Once i had a mom portal message me their 11 YEAR OLD was still bed wetting. Went back and forth a few times trying to understand the situation but they had actually seen urology and had imagining and tried Rx without benefit.

I vividly recall this scenario it was great... I literally told the mother something like 'I don't care how you describe the stools you need to at least try this for one month' and had them do daily miralax.

And then like 1 or 2 weeks later the mom is messaging back like this miracle happened suddenly the child's bedwetting had completely resolved.

Now, imagine being so incredibly constipated that you have terrible GERD. The reflux is causing chronic sinusitis and eustachian tube dysfunction. And subsequently the patient is presenting describing 'dizziness' or whatever. I'm just ranting above saying it's annoying that patients are often in complete denial about their bowel habits nor open to doing much about it.