Bedwetting
- Bedwetting also called night time incontinence or nocturnal enuresis — is involuntary urination while asleep .
- Bedwetting is a common problem among children, even after they have been toilet-trained.
Symptoms:-
- Usually, children stop wetting the bed between 3 and 5 years of age.
- Bedwetting is considered a problem if the child is over age 7 and continues to wet the bed two or more times a week for at least three months in a row.
Types of bedwetting:-
- Primary Nocturnal Enuresis:- It is a condition in which the person has never remained dry throughout the night for six months in a row or longer.
- Secondary Nocturnal Enuresis:-
- It is a condition in which the child has started wetting the bed again after not wetting the bed for six months or more.
- Secondary enuresis is more likely to be caused by a medical or psychological condition.
Causes of Bed wetting:-
Usually, there is not one medical or psychological condition that causes bedwetting.More commonly, there are many factors that could cause bedwetting, including:-
- Family history: Children with a parent or parents who were bedwetters are more likely to wet the bed.
- Constipation: Pressure from extra stool inside the rectum may interfere with the nerve signals that the bladder sends to the brain.
A full rectum can also reduce the amount of urine that the bladder can hold or prevent it from emptying completely during urination.
- Hormones: A hormone called vasopressin limits the volume of urine that the body produces during the night.
Children who do not produce enough vasopressin might be more likely to wet the bed.
- Small functional bladder capacity:-Children with small functional bladder capacity have normal-sized bladders, but they sense that their bladders are full even when the bladder can still hold more urine.
So.,they also are more likely to wet the bed during the night.
- Failure to awaken during the night:-Sometimes children are unable to wake up in time to get to the bathroom. A full bladder continues to send signals to the brain so that the child will awaken.
Bedwetting happens when the child has not yet learned to respond to these internal signals.
- Psychological or emotional problems: Emotional stress caused by traumatic events or disruptions in a child’s normal routine can cause bedwetting.
- Medical conditions: Disorders that are associated with bedwetting include urinary tract infections, diabetes, sickle cell disease, and sleep apnea.
Neurological problems or kidney or bladder abnormalities may also be causes.
Diagnosis:-
- Physical examination
- Discussion of symptoms, fluid intake, family history, bowel and bladder habits, and problems associated with bed-wetting
- Urine tests to check for signs of an infection or diabetes
- X-rays or other imaging tests of the kidneys or bladder to look at the structure of the urinary tract
- Other types of urinary tract tests or assessments, as needed
Management/Treatment:-
- Limit fluids in the evening.
- Avoid beverages and foods with caffeine.
- Encourage double voiding before bed.
- Doctor may prescribe medication for a short period of time to stop bed-wetting.Such as:-desmopressin etc.
- If your child has a small bladder, an anticholinergic drug may help reduce bladder contractions and increase bladder capacity, especially if daytime wetting also occurs
