What to do if your child has bedwetting or enuresis

Enuresis or urinary incontinence is a pathology that occurs in children over the age of 5 years, more often in boys. Although adult men, women, adolescents and young girls can also experience problems from this non-physiological condition.

Characteristics of pathology

Enuresis is a syndrome of involuntary, uncontrolled urination. If this condition appears exclusively at night, during sleep, this indicates that there is no control over urination during sleep. The daytime form of pathology is less common. Most often, the consequence of this pathology is a severe psychosomatic trauma, which actually causes a malfunction in the nervous system.

Nocturnal enuresis has been known for a very long time; there is a mention of it even among the doctors of the ancient Egyptians. Although medicine has made great strides forward since that time, so far no method of therapy gives an absolute guarantee of achieving a result.

Important! Modern medical science considers nocturnal manifestations of enuresis not so much a pathology as a stage of development. A child in infancy has little control over his reflexes. It is considered the norm if by the age of 6-7 the child already knows how to control his urinary tract at any time of the day or night.

  • By the age of 6, 10% of children: boys and girls cannot normally control the process of urination.
  • At 10 years old, there are already fewer such children, only 5%.
  • By the age of 18, only 1% have a problem.
  • The data for adults is as follows: every 200 people from time to time cannot control their bladder.

That is, of the total number of people suffering from this problem, 94% are children, 5% are adolescents and 1% are adults. In males, more frequent enuresis is observed, almost 2 times more cases. As for women, they suffer more from it in old age.

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It is noticed that short thin children are more prone to enuresis. Among the risk groups are also those with infectious diseases of the kidneys and bladder. Parents need to be careful, because often this is how the psychological protest of their crumbs manifests itself. And the child can also try to attract attention to himself in this way, if it is not enough, or, on the contrary, reduce overprotection.

Main reasons

There may be many reasons for this condition, among the most common are the following groups: psychological and physiological. If you look, in general, the list of reasons is as follows:

  • Hereditary factor. If one of the relatives has enuresis, then with a probability of 50% it will manifest itself in the child. If both parents are haunted by such a problem, then the likelihood of developing it in a son or daughter is 80%.
  • Physiology. Often the reason is the reduced physiological capacity of urea. It’s all just that the child physically cannot keep urine in it, which accumulates, for example, overnight.
  • Injuries and concomitant diseases. In this case, there are a number of factors that provoke this condition. Among them: birth trauma to the head during childbirth, brain damage, neuroses, urological pathologies, complex forms of dermatitis.

In addition, it is possible to highlight the reasons that are characteristic of certain categories: young boys and girls, adolescents and adults. They should also be considered.

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Boys under 5

Interestingly, as many as 10% of boys under the age of 15 face such a pathology. And when at 4 years old the situation with a wet bed is more or less perceived by the parents and the child himself, then leaving puddles in the bed at 11 years old is somehow “indecent”. But it’s worth understanding. That scolding a child for this is not the best way out, then problems will arise not only with urination, but also with a psychological state. Among the reasons that provoke the development of incontinence at a young age in boys are:

  • The conditioned reflex is not yet fully formed. The central nervous system of each child develops uniquely, therefore, in some, the conditioned reflex to restrain urination at night is formed in someone earlier, in others later.
  • Hyperactivity. In boys, this condition is observed 4 times more often. The problem arises because increased activity in the cerebral cortex literally suppresses natural urges.
  • Stress, a powerful emotion, is often negative. Situations that are associated with fear, nervous overstrain are quite capable of provoking enuresis.
  • Violation of the glands and hormonal balance. If a child is too thin and “small” for his age, he clearly has problems with growth hormone. He, among other things, is responsible for the process of urination.
  • Diaper habit. In recent decades, they have been blamed for the problem. Such an opinion is not even dismissed by the well-known specialist Dr. Komarovsky. Here everything is just a child gets used to the fact that you can urinate whenever you want. That is why this convenient hygiene product should be abandoned for up to 2 years.

Little girls

Although girls are less likely to suffer from this problem, they can still have it.

Fact! For the girl, it is easier and faster to cure the problem and get rid of wet sheets at night. This is due to the specifics of the nervous system.

But there are still certain factors for the development of such a violation:

  • The same as in boys: an unformed reflex, psychological trauma, stress.
  • The child drinks a lot of fluids before bed. Girls like to arrange evening tea parties more often.
  • A very sound sleep. The child’s body simply does not feel the urge to urinate, as it sleeps very soundly.
  • Semiuria – an increased volume of urine is released at night. Girls are more likely to suffer from this condition.
  • Mental retardation. In this case, biologically, the age will not coincide with the calendar. As a result, the reflex has not yet been formed.

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Causes of bedwetting in adolescents

At the age of over 15 years, such violations are observed much less frequently. Sometimes it occurs precisely at this age, but more often it lasts from infancy. Among the reasons are:

  • Disorders of the parts of the nervous system that are responsible for the formation of a conditioned reflex.
  • Injury and heredity.
  • Pathology of the kidneys, bladder, urinary tract. During an exacerbation of characteristic diseases, control over urination may be lost.
  • Mental problems, stress. Adolescence is associated with depression, neuroses. This provokes “childhood” diseases.
  • Hormonal adjustment. At this moment, there are serious changes in the work of the hormonal system, including the process of bowel movement.

Problems in adulthood

Here, the problems are the same as in the categories mentioned above – this is not a formed reflex. But it happens that you have to face the problem for the first time already as an adult. There are several reasons for this:

  • Congenital pathologies of the urinary system. Namely: small capacity of urea, thick and/or inelastic walls.
  • In women, similar problems can appear during menopause.
  • Tumors. Neoplasms can interfere with proper signal transmission to the brain.
  • Weakness of the pelvic muscles, pelvic floor. This occurs in women after pregnancy and in old age.
  • Aging of the brain. With age, impulse connections are disrupted, which leads to the fact that the signal from the urea does not reach the brain.
  • Weakening of the sphincter of the bladder.

Classification of enuresis

Before treating the condition in question with tablets or folk remedies, it is necessary to determine its type. The classification, including the ICD, is extensive and should be considered in more detail.

Development history

If these problems were not observed in childhood and developed after 5 years, this complexity is called primary. If the problems come from childhood, but at the same time there is a “dry” period of at least 6 months, then this type has a name – secondary or recurrent. In this case, very often a relapse is associated with an exacerbation of chronic pathology of the urinary system.

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By time

  • Night. This condition is observed in 85% of children, often the reason is a very deep sleep.
  • Day. Diagnosed in 5%
  • Mixed. It affects about 10%.

Moreover, the last 2 types are more often associated with neurological and/or emotional problems.

For concomitant pathologies

It can be complicated and uncomplicated. In the first case, it develops against the background of urinary tract infections, pathological neuralgia. As for the uncomplicated type, there are no other non-physiological conditions that go beyond the age norm.

Symptoms of bedwetting

Of course, the main specific symptom is the inability to control urination. In addition, you can highlight:

  • Difficulty falling asleep and waking up.
  • Deep sleep and nightmares are possible.
  • Children can talk in their sleep. When trying to wake up, unreasonable fear, a violation of spatial orientation may occur.
  • Daytime symptoms will be lethargy, drowsiness.
  • In the evening, there is hyperactivity, rapid mood swings.
  • The child will be fussy, his appetite is unstable, he is constantly thirsty.

Important! All symptoms, except for involuntary urination, are not specific. Their reasons may be other pathologies or simply lack of upbringing. For example, parents will allow you to watch TV for a long time. In the evening, active games are offered. One of the reasons for poor sleep, according to many parents and professionals, is too hearty late dinner.

Treatment

It is quite possible to treat, or rather, to deal with the problem at home, there is no need for a hospital. The first step is an examination, but it makes sense to conduct it if the problem has not disappeared after 6 years. Among the diagnostic measures, ultrasound of the bladder and kidneys is prescribed, in addition, MRI is prescribed according to indications.

There are many effective methods and medicines are not always needed. Among the groups of methods, the following are distinguished:

  • Medication.
  • Non-drug.
  • Regime.

Important! Alternative treatment with herbs and decoctions can give results, but numerous tips to use conspiracies and prayers are more likely a method of calming down for parents. The effectiveness of such “treatment” is questionable and cannot be verified in any way. Therefore, you should not experiment on your own child.

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Medication

This type is used if the cause of incontinence is physiological and associated with diseases of the urinary system. For example, a child may be prescribed sedatives for hyperactivity, neurosis-like enuresis. If an infection is detected, antibiotics are prescribed, as the doctor determines, given the condition.

If enuresis is a consequence of a delay in the development of the nervous system, then nootropic drugs are prescribed. They are able to speed up lagging processes.

Among the effective drugs that can be prescribed for adults and children:

  • “Enuresol” – can be used to treat urinary incontinence in both adults and children. Important properties: reduces nervous tension, makes a person more resistant to stress, relieves stress, makes sleep less deep.
  • “Minirin” – is prescribed for children over 5 years of age and adults for the treatment of primary nocturnal enuresis.
  • “Picamilon” – refers to nootropic drugs that improve brain activity.
  • Melipramine is an antidiuretic and antidepressant. It is often prescribed for adults to reduce tension, panic attacks.

The cost of treatment with these drugs is quite affordable, but many types of enuresis can be cured without the use of drugs.

Non-drug treatment

This method is most often prescribed to children 8-11 years of age and older if they have problems with nocturnal enuresis. To a certain extent, such therapy can be called prevention, since its main task is to prevent the main manifestation of the disease. Techniques:

  • Use of urinary alarms. A small sensor is placed in the child’s panties, as soon as the first drop of urine hits it, it signals this. The child only needs to get up and go to the toilet.
  • Physiotherapy. A wide variety of techniques are used.
  • Psychological help, if the reason is psychosomatics.

Important! To prevent trouble from happening at night, you should reduce the amount of fluid you drink, especially after dinner.

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Regimen therapy

This method requires special care from the parents. Instructions on how to proceed:

  • There should be a bedtime regimen. That is, the child should always go to bed at the same time.
  • 4 hours before bedtime, exclude active games. Better to invite him to draw, read.
  • Attention should be paid to the bed. There should be slight elevations in the area where the pelvis and knees lie. This helps to relieve pressure on the bladder.
  • The child should not be hypothermic.
  • Before going to bed, be sure to visit the toilet. And also need night awakenings 2 or 3 times. Moreover, it is important that during his wet affairs, the child does not doze.
  • Often the problem is that the child is afraid of the dark, and he would rather sleep in a wet one than go to the toilet.

Important! If, after all these efforts, the bed is still wet in the morning, in no case should you scold the child. This will only frighten him and make the problem in his eyes very big, which means that it will be even more difficult to cope with it.

Folk treatment

Such funds are numerous, but not all of them are effective enough, so you should not rely on them alone. Some of the options to try:

  • Dill seeds. Brew 1 tbsp. l seeds 200 ml of boiling water and insist for 1 hour. Drink in the morning before meals for 0,5-1 glass. The course of treatment is 10 days.
  • Honey. Before going to bed, give the child 1 teaspoon of honey. This natural product soothes and retains moisture. Gradually, the dose of the sweet medicine should be reduced.
  • Exercise “Walking on the buttocks”. You need to sit on the floor with straight or slightly bent legs and move along the floor, “walking” with your buttocks. The distance is 1,5-2 meters.
  • Tea with St. John’s wort and centaury.
  • Give your child a salty product before bedtime that will retain moisture: a piece of herring, bread and butter, sprinkled with salt.

Conclusion

The fight against enuresis can take a long time if the cause is not identified and the correct treatment method is not chosen. It should be understood that no modern method guarantees a 100% cure, a relapse is possible.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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