What is bed wetting?
The clinical term for bed wetting is called Enuresis.
It is the involuntary or reflex urination by a person when sleeping usually after the age four or five when a person should be able to control the bladder.
During thus period, Infants and children lose the will and as a result do unintentional urination.
Although, majority of these children are able to apply daytime control but not in the night time.
The bladder control varies depending upon age. Some parents expect dryness at the early age.
Nocturnal Enuresis is defined as
the incapability of a child to hold the bladder, but urinates unfortunately while sleeping.
*Prevalence of Enuresis/ Bed wetting*
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 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 bed wetting?
There are two main types of nocturnal enuresis and these are:
(i)Primary bed wetting:
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 bed wetting starts after the child has been dry at night for a significant period of time, at least 6 month.
What are the risk factors of bed wetting?
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 abnormal function of kidney or bladder or neurological system.
**Attention Deficit Hyperactivity Disorder (ADHD)
**Some medications may trigger enuresis.
What are the causes of Bed Wetting?
The actual causes of bed wetting has not yet been known by medical experts.
But there are various developmental conditions which could cause bed wetting.
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.
Sleep problems: sometimes deep sleep may cause bed wetting in children and even teenagers to the extent that they don’t wake up when they want to pee. Sometimes bedwetting is the sign of obstructive sleep apnea.
Bladder problem: Some times, children may have a small bladder or not developed properly. This cannot be able to hold urine which is produced during the night. As a result, they pee uncontrollably at night.
Genetics: Teenagers with enuresis/ bed wetting 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.
Medical conditions: 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 bed wetting . But it is rare.
Psychological problems: Some doctors believe that stress or tension can be associated with bed wetting.
What are the Symptoms of bed wetting?
A lot of people will wet their bed only at night. Yet They will not have other symptoms than bed wetting. Nevertheless, some physiological problems which are associated with nervous system or kidney may cause the signs and symptoms.
These include the following:
1. Bedwetting during the day.
2. Frequency, urgency or burning during urination.
3. Dribbling, straining or other unusual symptoms with urination.
4. Being unable to control bowel movements.
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.
What are the ways to prevent bed wetting?
1. Parents should encourage their children by being positively and should make them understand how the bed wetting will affect their social life.
2. Wake up your child several times to go to toilet and urinate.
3. Encourage your child to urinate before bedtime and several times in a day, that makes your child as routine habit
4. Avoid beverages and food that contain caffeine before bedtime.
5. Reduce the amount of water taken before bed time.
6. Ensure they do a lot of exercise to remove excess water through profuse sweating or perspiration , so that little or less water will be passed out in urine.
What are the Medical treatment for bed wetting?
Bed wetting that is caused from other medical conditions can be cured by doing medications.
Medications can treat the variety of which bed wetting 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.