What is bedwetting?
Bedwetting, also called nocturnal enuresis, is the involuntary passage of urine (urinary incontinence) while asleep. Inherent in the definition of bedwetting is satisfactory bladder control while the person is awake.
The cause is likely due to one or a combination of the following:
- The child cannot yet hold urine for the entire night.
- The child does not waken when his or her bladder is full.
- The child produces a large amount of urine during the evening and night hours.
- The child has poor daytime toilet habits. Many children habitually ignore the urge to urinate and put off urinating as long as they possibly can. Parents are familiar with the "potty dance" characterized by leg crossing, face straining, squirming, squatting, and groin holding that children use to hold back urine.
Secondary bedwetting can be a sign of an underlying medical or emotional problem. The child with secondary bedwetting is much more likely to have other symptoms, such as daytime wetting. Common causes of secondary bedwetting include the following:
- Urinary tract infection: The resulting bladder irritation can cause lower abdominal pain or irritation with urination (dysuria), a stronger urge to urinate (urgency), and frequent urination (frequency). Urinary tract infection in children may indicate another problem, such as an anatomical abnormality.
- Diabetes: People with type I diabetes have a high level of sugar (glucose) in their blood. The body increases urine output as a consequence of excessive blood glucose levels. Having to urinate frequently is a common symptom of diabetes.
- Structural or anatomical abnormality: An abnormality in the organs, muscles, or nerves involved in urination can cause incontinence or other urinary problems that could show up as bedwetting.
- Neurological problems: Abnormalities in the nervous system, or injury or disease of the nervous system, can upset the delicate neurological balance that controls urination.
- Emotional problems: A stressful home life, as in a home where the parents are in conflict, sometimes causes children to wet the bed. Major changes, such as starting school, a new baby, or moving to a new home, are other stresses that can also cause bedwetting. Children who are being physically or sexually abused sometimes begin bedwetting.
- Sleep patterns: Obstructive sleep apnoea (characterized by excessively loud snoring and/or choking while asleep) can be associated with enuresis.
- Pinworm infection: characterized by intense itching of the anal and/or genital area.
- Excessive fluid intake.
Bedwetting tends to run in families. Many children who wet the bed have a parent who did, too.
Primary Functional Enuresis
(Chronic Bed-wetting)
Cause:
Chronic bed-wetting is thought to be related to
Chronic bed-wetting is thought to be related to
(1) a physically and/or neurologically immature bladder and/or
(2) a deep sleeping pattern.
Apparently these children often sleep so deeply that they are not aware of the message the bladder sends to the brain saying it is full. It is presumed that bed-wetting is an inherited condition. Usually a parent, aunt, uncle, grandparent or other family member(s) will have had the condition. Also, children with attention deficit disorder, learning disabilities or allergies seem to be more likely to be bed-wetters than children in the general population.
Effect of Bed-wetting on the Child and Family:
By the first grade, most children are embarrassed by their bed-wetting condition. They tend to withdraw from social activities that require sleeping outside their home. They also often suffer from low self-image. These children's feelings can be greatly affected by the attitudes of their parents, who may feel that their efforts to end the bed-wetting have failed. Parents may also feel frustrated, angry and embarrassed about their children's bed-wetting condition. Parents can help their children reduce negative feelings about their bed-wetting condition and speed up the process of overcoming it, by offering positive support, understanding and encouragement.
Treatment:
First of all, almost all children outgrow their bed-wetting habit. As children mature, their muscles become stronger and their bladder capacity increases. They tend to sleep less deeply and to become more sensitive to messages the bladder sends to the brain. There are two approaches to treatment: Medical or Behavioural. The medical treatment usually consists of the use of one of two drugs:
Behavioural treatment is often more effective and certainly is safer than medical treatment. While behavioural treatment may take somewhat longer to show results, the improvement usually continues indefinitely. There are several methods that may be helpful:
Retention Control Training: The child is asked to control urinating during the day by postponing it, first by a few minutes and then by gradually increased amounts of time. This exercise can extend the capacity of the bladder and strengthen the muscle that holds back urination. Parents should always check with a doctor before asking their child to practice retention control.
Night-lifting: This procedure involves waking your child periodically throughout the night, walking your child to the bathroom to urinate, and then returning your child to bed. By teaching your child to awaken and to empty his or her bladder many times during the night, it is hoped that he or she will eventually stay dry.
Moisture alarm: Moisture alarms are considered a useful and successful way to treat bed-wetting. Medical research has shown that moisture alarms have helped many children stay dry. This treatment requires a supportive and helpful family and may take many weeks or even several months to work. Moisture alarms have good long-term success and fewer relapses than medications.
An alarm consists of a clip-on sensor probe that attaches to the outside of bed-clothing. An alarm is set off when the child begins to wet the bed. The alarm wakes the child, who will then go to the bathroom to finish and then go back to sleep. This slowly conditions the brain to respond appropriately during sleep to messages from the bladder.
Homeopathy Medicine Treatment for Bed Wetting
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