Nocturnal Enuresis – Bedwetting Treatment in Jaipur: Hello everyone, Bedwetting is a condition when someone passes urine in their sleep after the age at which staying dry at night can be reasonably expected. It is a fairly common condition specially in boys. If a child wets the bed consistently at least 2 times in a week for 3 months or more, it should be evaluated by a good urologist. Also, if a child starts wetting the bed after staying dry for 6 months or more, a visit to a urologist is a good idea.
In majority of children with bedwetting issue, there is no medical disease as such. An underlying disease is found in only about 1% of the children with bedwetting. Always remember that a child who wets the bed does not do it on purpose. This child is not misbehaved, lazy, defiant or troublemaker. Never blame the kids for this issue, it is not in their control. Bedwetting is mainly a developmental issue.
Broadly speaking there are two types of Bedwetting (Nocturnal Enuresis)
- Primary Bedwetting
- Secondary Bedwetting
Primary bedwetting is when a child has never stayed dry at night for a considerable number of nights. This means, the child has continued to wet the bed since infancy and has never had night time control on the bladder. It could be due to the following reasons:
- The bladder of some of the children may need extra time to develop control. Hence, the child is unable to hold urine for the whole night.
- Sleep hygiene also plays a role. Sometimes the sleep of the child is disturbed due to snoring (of parents or others sleeping in the same room), television, music, pets. In addition to this, it is seen that some children who are deep sleepers also have bed wetting issue.
- Some children drink a lot of water at night time due to which they produce a lot of urine at night. This can be a contributing factor for bedwetting.
- Poor day time toilet habits such as holding urine for a long time and ultimately making this a habit. Such children can be seen making straining faces when the urge gets strong.
Usually secondary bedwetting is associated with some other problem the child might be dealing with. For example, an underlying medical problem or emotional status of the child. It is interesting to note that, a child with secondary bedwetting also may have wetting troubles during the day sometimes. Some of the reasons for secondary bedwetting include
- Big life changes like moving in to a new home, new sibling, new school can be a source of stress for a child and this can result in bedwetting in a child who was previously dry. Also, children who live in stressful environment like parental conflicts can develop bedwetting. Another possibility is children who are physically or sexually abused also start bedwetting sometimes.
- Urinary Tract Infection is a common cause for secondary bedwetting in children. The urgency and increased frequency of passing urine makes it difficult for children to hold urine.
- Chronic constipation which is another common entity in children can sometimes contribute to secondary bedwetting.
- Other causes which may sometimes result in secondary bedwetting include – any anatomical abnormality, neurological problems, sleep apnea. Bedwetting is also commonly seen in kids who have Attention Deficit Hyperactive Disorder (ADHD). In adults, Type 1 Diabetes can also first show up as bedwetting. This is often accompanied by thirst and increased urination as the body tries to excrete the excess sugars through urine.
Diagnosis of Bedwetting
The diagnosis of bedwetting is purely on the basis of history given by the parents in case of children. However, if the enuresis is secondary, the urologist may ask for some basic tests in order to rule out UTI, constipation etc. If any anatomical problem is suspected then tests are carried out accordingly.
Treatment of Bedwetting
Conservative Home Based Treatment – Behaviour Therapy
It is important to know that, by the age of 5 to 7 years, most of the children outgrow the habit of bedwetting. However, it is important to consult the urologist as he will be able to rule out any other problem. Then best course of treatment can be decided for the child. (Make sure a toilet is easily accessible to the child, also its easy for him to urinate comfortably)
Behaviour Therapy helps child learn that it is not right to wet the bed. Some of the steps taken in behaviour therapy include:
- Limiting the intake of water and other fluids late at night, before bed.
- Having the child pass urine before going to bed once or twice.
- Enuresis Alarm System uses a device which rings or vibrates as soon as the child wets the bed. This helps child understand the bladder sensation and respond to urge.
- Whenever the child is dry at night, the child should be given a positive reinforcement (like stars or stickers) to award the good behaviour. However, never punish for an accident.
- Child is asked to hold urine during the day for as long as possible. This therapy helps stretch the bladder muscles in order to improve bladder capacity.
- Psychological counselling can help in cases where the child has dealt with a stressful situation.
Medicines for Bedwetting
If behaviour therapy does not work, the urologist after much consideration may give a small course of medicines. Medicines are given mostly in older children. Medicines can help increase the bladder capacity, thus helping to hold more urine. Or medicines can help decrease the rate of urine formation. Therefore it is important to consult a good urologist as he is the expert and will guide you correctly with the treatment plan.
Can Bedwetting be inherited?
Many times, if a child has bedwetting issues, it is likely one of his parents did too as a child. Bedwetting is seen to have an inclination to families. In such cases, children usually stop wetting the bed around the same age as their parent stopped.
Why you must never Ignore Bedwetting
Bedwetting can be a cause of shame, embarrassment and low self esteem. A child can feel all this due to which their performance at school as well as society is affected. If the family is not supportive, the child may live under constant guilt which may further add to the stress. Child may not want to take part in activities which require staying away from home like camps. Therefore, even if you think bedwetting is not harming the child in any way, and it’s only the parents who struggle, think again!
We are here to help. Our team of experts are here to guide you and support you in the best possible way. Give us a call on (0091) 9829013468 for more information and further queries.