What is bedwetting?
The clinical term for bedwetting is called Enuresis
It is the involuntary or reflex urination by a person when sleeping usually after the age of four or five when a person should be able to control the bladder.
During this period, Infants and children lose the will and as a result, do unintentional urination.
Although, the majority of these children are able to apply daytime control but not in the nighttime.
Bladder control varies depending upon age. Some parents expect dryness at an early age.
Nocturnal Enuresis is defined as
the incapability of a child to hold the bladder but urinates unfortunately while sleeping.
*Prevalence of Enuresis/ Bedwetting*
Enuresis is one of the most prevalent and frustrating disorders of childhood. A child expected to sleep dry at night time without urinating on the bed between the ages of 2 and 4. However, at 4years, about 25% of children still wet the bed; at 5years, about 20%; at 6years, 15%; 10years, 8%; at about 14, years 4%; and at about 18 years and more than 2% of the population are still bed wetter’s.
What are the types of bedwetting?
There are two main types of nocturnal enuresis and these are:
This starts from the early stages of the child from 0 to 6months. At this stage, the child is not yet achieved nighttime dryness over a period of six consecutive months.
(ii) Secondary bedwetting:
This type of bedwetting starts after the child has been dry at night for a significant period of time, at least 6 months.
What are the risk factors of bedwetting?
The risk factors for the cause of enuresis include the following:
**Family history plays a role in enuresis.
**Urinary tract infection.
** Intake of excessive water before bedtime.
**Medical conditions such as the abnormal function of kidney or bladder or neurological system.
**Attention Deficit Hyperactivity Disorder (ADHD)
**Some medications may trigger enuresis.
What are the causes of bedwetting?
The actual causes of bedwetting have not yet been known by medical experts.
But there are various developmental conditions that could cause bedwetting.
These include the following:
A hormone called antidiuretic hormone causes the body to produce less urine at night time. In some cases, the human body does not produce the ADH hormone and this results in the increased production of urine when the person is sleeping.
sometimes deep sleep may cause bedwetting in children and even teenagers to the extent that they don’t wake up when they want to pee. Sometimes bed-wetting is a sign of obstructive sleep apnea.
Sometimes, children may have a small bladder or not developed properly. This cannot be able to hold urine that is produced during the night. As a result, they pee uncontrollably at night.
Teenagers with enuresis/ bedwetting often have a Parent who had the same problem at about the same age. scientifically identified the specific genes that cause enuresis.
Caffeine: Caffeine can cause a person to urinate more especially at night when the body is at rest.
Some medical conditions may also cause secondary enuresis. Medical conditions include diabetes, urinary tract abnormalities (problems with the structure of a person’s urinary tract), constipation, and urinary tract infections (UTIs). Spinal cord injury may also play a role in bedwetting . But it is rare.
Some doctors believe that stress or tension can be associated with bedwetting.
What are the Symptoms of bedwetting?
A lot of people will wet their bed only at night. Yet They will not have other symptoms than bedwetting. Nevertheless, some physiological problems which are associated with the nervous system or kidney may cause the signs and symptoms.
These include the following:
Bedwetting during the day.
Frequency, urgency, or burning during urination.
Dribbling, straining, or other unusual symptoms with urination.
Being unable to control bowel movements.
The frequency of urination will vary from children to adult.
While adults may urinate only three or four times in a day, children urinate frequently more than adults, in some cases, they may urinate 10 to 12 times a day.
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What are the ways to prevent bedwetting?
1. Parents should encourage their children by being positive and should make them understand how bedwetting will affect their social life.
2. Wake up your child several times to go to the toilet and urinate.
3. Encourage your child to urinate before bedtime and several times in a day, that makes your child a routine habit
3. Avoid beverages and food that contain caffeine before bedtime.
5. Reduce the amount of water taken before bedtime.
6. Ensure they do a lot of exercises to remove excess water through profuse sweating or perspiration, so that little or less water will be passed out in the urine.
What are the Medical treatment for bedwetting?
Bedwetting that is caused from other medical conditions can be cured by doing medications.
Medications can treat the variety of which bedwetting is a symptom. For example:
- The drug desmopressin (DDAVP) and imipramine (Tofranil) reduces urine production at night.
It is given orally or as a tablet but only for children more than 5-year-old.
If your bladder is smaller, an anticholinergic drug such as oxybutynin (Ditropan XL) can be used to reduce bladder contractions and to increase bladder capacity. It is used along with other medications and it is generally recommended when other treatments have failed.