Bed Wetting

Description

     Bed-wetting also called nighttime incontinence or nocturnal enuresis  is involuntary urination while asleep after the age at which staying dry at night can be reasonably expected Many children wet the bed until they are 5 or even older. Soggy sheets and pajamas and the embarrassed child are a familiar scene in many homes.  It is probably a time when parents need to worry and look for the treatment so that their kid is free from embarrassment and anxiety. A child’s bladder might be too small or the amount of urine produced overnight can be more than the bladder can hold. Some children sleep too deeply or take longer to learn bladder control. Stress can also be a factor. Children should not be punished for wetting the bed. They don’t do it on purpose and most outgrow it.

     Bed-wetting isn’t a sign of toilet training gone bad. It’s often just a normal part of a child’s development. The doctor will look for and treat any other heath problems that could cause the bedwetting. Life style changes, bladder training, moisture alarms and sometimes medication may help reduce bed-wetting. he best thing parents can do is to motivate their kids and share the experiences to boost up the moral support symptoms

     Most kids are fully toilet trained by age 5, but there’s really no target date for developing complete bladder control. Between the ages of 5 and 7 bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed. however, if a kid exceeds 7 years of age and still is found to urinate at night this is a time where you must consult a pediatrician.

Types of Bed wetting

  1. Primary bed wetting (bedwetting that has been ongoing since early childhood without a break).
  2. Secondary bed wetting (bedwetting that starts again after the child has been dry at night for a significant period of time (at least six months).

Causes for bedwetting

  • Child with small bladder which is not capable of holding urine in large quantity during night.
  • While bedwetting can be a symptom of an underlying disease, the large majority of children who wet the bed have no underlying illness.
  • The child cannot yet hold urine for the entire night.
  • Late maturity of nerve that controls the bladder, when the nerve is not mature, even a full bladder might not be able to wake your kid up for urination.
  • A stressful home life, as in a home where the parents are in conflict sometimes causes children to wet the bed.
  • A hormone imbalance. During childhood, some kids don’t produce enough antidiuretic hormones (ADH) to slow nighttime urine production. a hormone called antidiuretic is not produced in sufficient quantities and hence kid keeps on producing urine in larger quantities at night.
  • The child produces a large amount of urine during the evening and night hours.
  • For a child who’s usually dry at night, bed-wetting may be the first sign of diabetes. Other signs and symptoms may include passing large amounts of urine at once increased thirst, fatigue and weight loss in spite of a good appetite.
  • Pinworm infection characterized by intense itching of the anal and/or genital area.
  • 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.
  • Stressful events such as becoming a big brother or sister, starting a new school or sleeping away from home  may trigger bed-wetting
  • Sleep apnea is also caused by inflammation of tonsils or other sinus infections. It can also contribute to bed wetting.
  • Chronic constipation can cause nocturnal enuresis. The same muscles are used to control urine and stool elimination. When constipation is long term these muscles can become dysfunctional and contribute to bedwetting at night.
  •  Abnormalities in the nervous system or injury or disease of the nervous system.
  • Urinary tract infection, The resulting bladder irritation can cause lower abdominal pain or irritation with urination.
  • The antidiuretic hormone produced by the body regulates the amount of urine released by the kidneys.
  • Excessive fluid intake.

Symptoms for Bed wetting:

  • Bed wetting is more common in boys as compared to girls.
  • Your child still wets the bed after age 7.
  • Most people who wet their beds, wet only at night. They tend to have no other symptoms other than wetting the bed at night. Wetting during the day.
  • Frequency, urgency or burning on urination.
  • Sudden urge to urinate.
  • Your child starts to wet the bed after a few months of being dry at night.
  • Straining, dribbling or other unusual symptoms with urination.
  • Increase in thirst.
  • Cloudy pinkish urine or blood stains on underpants or pajamas.
  • Soiling, being unable to control bowel movement.
  • Snoring.

Diagnosis:

  • Physical exam.
  • 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.

Treatment:

  • The drug Desmopressin (DDAVP) reduces urine production at night. Desmopressin is given orally as a tablet and is only for children over 5 years old.
  • If your child has a small bladder, an ant cholinergic drug such as oxybutynin may help reduce bladder contractions and increase bladder capacity, especially if daytime wetting also occurs.
  • Bladder exercises help stretch the muscle that controls the release of urine from the bladder and increase bladder capacity.

Sometimes a combination of medications is most effective. There are no guarantees medication doesn’t cure the problem.

How to cure:

  • Encourage your child to hold off going to the bathroom for some time when the urge to urinate begins.
  • Make it a habit of your child to go to the bathroom before sleeping.
  • Electronic bedwetting alarms detect wetness and trigger an alarm if the child starts to pee.
  • Give your kid 2-3 bananas each day. It will help you to treat the problem of bedwetting in your child.
  • Cranberry juice is good for the bladder and urinary tract. It is highly recommended for children with bedwetting problems.
  • Give your child a piece of jaggery to eat post meals.
  • Encourage your child to use the bathroom just before bedtime, as sleeping with an empty bladder will help minimize the risk of nighttime accidents.
  • You can even put a tablespoon of honey in his/her glass of milk, instead of sugar to cure the ailment.
  • Encourage your child to drink more fluids during the morning and afternoon but limit fluid intake during the last few hours before turning in for bed.
  • During the day and evening, suggest that your child urinate every two hours or at least often enough to avoid a feeling of urgency.

Risk Factor:

  • Painful or burning sensations while urinating.
  • Straining to urinate.
  • Wetting accidents during the day.
  • Daytime and nighttime wetting.
  • A sudden change in personality or mood swings.
  • Swollen feet.
  • Lack of bowel control.
  • Unusual thirst.

Children who wet the bed are not lazy, willful or disobedient

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