Nocturnal Enuresis (bedwetting)

Involuntary urine that occurs during the night while sleeping after an individual has attained the age when he or she ought to be capable of regulating his or her bladder is termed Nocturnal enuresis. (Diurnal enuresis refers to involuntary urine that occurs during the day.) Even when children have been toilet-trained, bedwetting is a regular problem.

As children become older, they usually stop wetting the bed on their own. Between the ages of 3 and 5, children often discontinue bedwetting (nocturnal enuresis). If a child is over the age of seven and wets the bed two or more times each week for three months in a row, it is considered a problem.

For some children, bedwetting (nocturnal enuresis) is a normal stage of development. In adults, however, it could be a symptom of a more serious illness or disease. Bedwetting causes about 2% of adults, and it can be caused by a variety of factors and may require treatment.

Although bedwetting is not a life-threatening condition, it can be stressful for both the child and his or her family.

Types of Nocturnal Enuresis (bedwetting)

1. Primary nocturnal enuresis is characterised by the inability of a person to remain dry for more than six months in a row.
2. Secondary nocturnal enuresis occurs when a child begins to wet the bed again after six months or more without wetting a bed. A physiological or psychological condition is more likely to trigger secondary enuresis.

Risk factors of nocturnal enuresis

• Bedwetting (nocturnal enuresis) can affect everyone, but boys are twice as likely as girls to experience it. A higher risk of bed-wetting has been linked to several circumstances, including:
• Anxiety and stress- One of the bedwetting causes can be traumatic situations like becoming a big sibling, beginning a new school, or staying away from home.
• History of the family- If one or both of a child’s parents wet the bed like youngsters, their child is more likely to do so as an adult.
• Attention deficit hyperactivity disorder (ADHD)- Children with ADHD are more likely to have nocturnal enuresis.

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Bedwetting Causes

It is usually caused by a combination of physical and psychological factors. A small number of children suffer from a medical problem that causes them to pee in the bed. Bedwetting is caused by a variety of circumstances, the most prevalent of which are:

1. Smaller than expected bladder capacity

It’s possible that your child’s bladder isn’t developed enough to contain pee produced during the night. A full bladder may not wake your child if the nerves that control the bladder are slow to mature, especially if your child sleeps deeply.

2. Hormonal imbalance

Some children may not produce enough antidiuretic hormone (ADH) during childhood, and bedwetting causes nighttime urine production to increase.

3. UTI

Your child’s ability to control urine may be harmed as a result of this infection. Bedwetting, daytime accidents, frequent urination, red or pink urine, and pain while urination is all signs and symptoms.
Also read: How to stop frequent urination

4. Apnea (sleep deprivation)

Bedwetting (nocturnal enuresis) can be a sign of obstructive sleep apnea, a disease in which a child’s breathing is disrupted while sleeping, which is commonly caused by inflamed or enlarged tonsils or adenoids. Other signs and symptoms include snoring and tiredness during the day.

5. Diabetes

Bedwetting (nocturnal enuresis) may be the first indicator of diabetes in a youngster who is normally dry at night. Other symptoms include passing big amounts of pee all at once, increased thirst, weariness, and weight loss despite a healthy appetite.

6. Constipation

Urine and stool evacuation are controlled by the same muscles. Long-term constipation can cause these muscles to become dysfunctional, which can lead to nighttime bedwetting causes.

Nocturnal Enuresis (bedwetting) Diagnosis

Your child’s paediatrician will inquire about how frequently this occurs, as well as any other symptoms. Keep track of your child’s bathroom habits in a bladder diary before your appointment. Include details for nocturnal enuresis treatment  such as:

• How often does your child have to go to the bathroom during the day and night?
• How frequently does he pass faeces, and how hard or soft is it?
• Does your child consume anything before going to bed?

If your child’s health care professional requires additional information, he or she may diagnose bedwetting (nocturnal enuresis) by:

• Urine culture and analysis: Urine tests are performed to look for infection, unwanted blood, and other substances in the urine.
• Blood test: Blood tests are conducted to diagnose nocturnal enuresis which helps to analyse the function of the kidney and thyroid, anaemia presence, cholesterol levels and diabetes or hormone issues.
• Bladder scan: This ultrasound determines how much pee remains in the bladder after urination for further nocturnal enuresis treatment.
• Urodynamic testing: This examines the ability of the lower urinary tract to hold and release urine.
• Cystoscopy: A doctor inserts a small tube into the bladder with a tiny lens to check for a tumour or other more serious diseases.

Nocturnal enuresis Treatment

Non-pharmacological nocturnal enuresis treatment

a) Limiting fluids before bedtime

Wait at least two hours before giving your child anything to drink. Ensure that your toddler drinks lots of water throughout the day.

b) Going to the bathroom before night

Make sure your youngster goes to the bathroom before bedtime and empties his or her bladder.

c) Enuresis alarm

This is a device used in nocturnal enuresis treatment that emits a loud noise or vibrates to wake up a youngster who is wetting the bed. The alarm is triggered by a moisture sensor, which allows the youngster to wake up and completely urinate in the bathroom. 

d) Bladder therapy

This method involves making the youngster wait to go to the bathroom to gradually increase the bladder’s functional capacity. Increasing the duration between bathroom visits allows the bladder to expand, allowing it to hold more urine.

Pharmacological nocturnal enuresis treatment

For this treatment consult the doctor. He/ she what suggested to understand that and start the following treatment.

a) Desmopressin

This is a man-made version of the hormone vasopressin, which reduces urine production in the kidneys. It works in roughly half of the instances, and it works better in older children with normal bladder capacity. Because the medication can cause a salt deficiency in children, you should limit the number of fluids your child consumes after supper.

b) Oxybutynin

It reduces bladder spasms and is used to treat hyperactive bladder. Oxybutynin can be combined with desmopressin or the enuresis alarm method for nocturnal enuresis treatment. It may be beneficial for youngsters who wet the bed more than once every night and also wet the bed during the day.

c) Imipramine

Although this medication is beneficial in 40% of cases, it should be used with caution due to the potential for major side effects.

The above-mentioned drugs are taken before consulting the doctor.

Hence, after consulting with your doctor, your doctor may prescribe you medicine according to your health condition. So, you can buy medicine at your nearest medical store or if you are looking for online medicine and also for free online doctor consultation. You can refer to our Truemeds physician which provides free online consultations. We also provide you with  PAN India home medicine delivery, with a discount offer, and monthly savings on your medical bill. 

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