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Childhood nocturnal enuresis

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Janice, a happy, healthy 8 year old, was made to wear her new jammies with pictures of her favorite cartoon character Dora. She was taken to the toilet before getting into bed. Her mother spoke to her about being careful and not soiling her new jammies in her sleep. Poor Janice could not help it and before she even realized it before it was dawn, her jammies were soaking wet. She woke up to a frowning mother who thought it is time to speak to a doctor. The pediatrician diagnosed her problem as childhood nocturnal enuresis.

Childhood nocturnal enuresis is simply defined as bedwetting. The problem is common among kids who tend to urinate spontaneously or involuntarily without realizing in bed. However, they tend to outgrow the habit as they grow up.

Primary nocturnal enuresis is considered when the child had not had a prolonged period of being dry in bed. Secondary nocturnal enuresis is considered for children or adults who begin to bedwetting after about 6 months of staying dry.

Do not consider every case of bedwetting as an emotional problem or physical illness. In majority of the cases, it is just a case of developmental delay for the child. Studies show girls start staying dry in bed by the age of 6 and in case of boys by the age of 7. Around 95% children remain dry in bed by the time they reach the age of 10.

We shall discuss more about childhood nocturnal enuresis in this article.

Symptoms of childhood nocturnal enuresis

The most common and obvious symptom is wetting the bed, that is, passing involuntary urine, while asleep after the age of 5 or after being fully toilet trained.

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What causes childhood nocturnal enuresis?

Primary bedwetting is not a disease and it is not associated with an infection in the urinary tract or the bladder.

The most probable reasons for childhood nocturnal enuresis are:

  • Children whose bladder is not completely developed may experience involuntary urination at night
  • Kids with underdeveloped nervous system tend to urinate involuntarily as they cannot sense when their bladder is full
  • Decreased production of antidiuretic hormone (ADH) at night. ADH controls night time urination
  • Children whose parents had a history of nocturnal enuresis, are at high risk of having nocturnal enuresis

Secondary nocturnal enuresis could be associated with medical conditions like urinary tract infection, anatomical defect in the urinary tract or childhood emotional stress.

When to see a doctor

You can always consult a doctor,if your kid’s bed wetting episodes are frequent or if he/she shows symptoms of secondary nocturnal enuresis.

Diagnosis of childhood nocturnal enuresis

Your doctor will ask several questions regarding the frequency of bedwetting, your child’s eating and drinking habits, general behavior as well as academic performance, etc. Parents need to tell doctors, if either of them had ahistory of childhood nocturnal enuresis.

In most cases, this simple evaluation helps to figure out appropriate ways to manage bedwetting.

However, if your doctor suspects any unusual causes, then your kid has to undergo different diagnostic tests like urine culture, psychological stress test, X rays, ultrasound of bladder and kidney. If the doctor suspects structural abnormalities, he/she may suggest other tests depending upon his/hersuspicions.

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Treatment of childhood nocturnal enuresis

For children under age 7 years, your doctor most likely won’t prescribe any medicines. The bladder develops with age and so children gradually get over the problem of nocturnal enuresis on their own.

Bedwetting alarms are also useful in managing nocturnal enuresis in children. The device works by sensing wetness in your child’s underpants or the pad he/she might be wearing. The alarm starts ringing;the kid can wake up and visit the toilet. However, it might a month or two (less or more) to get used to the alarm.

If your child sleeps deeply at night, then the parents should remain alert when the alarm rings. Make sure you inculcate the habit of waking your kid up from bed and urinate in toilets.

In case of severe nocturnal enuresis, doctors might consider prescribing Desmopressin and tricyclic antidepressants. These pills increase secretion of ADH hormones and thereby increase the holding capacity of the bladder.

The treatment of secondary enuresis depends completely upon the underlying cause.

Alternative treatment options for nocturnal enuresis

Motivation and psychological counseling help deal with emotional problems like embarrassment and stress that your kid might be suffering from due bedwetting at night. Children suffering from any form of abuse such as physical, emotional as well as sexual may require a lot of counseling to help overcome the anxiety that causes them to wet their bed.

Change of drinking and toilet habits must be applied practically. It implies minimizing fluid intake after evening and visiting the toilet at least twice before going to sleep.

This was all about childhood nocturnal enuresis. Speak to a pediatrician for more details and help your child overcome this habit with love, care and support.

Written by: healthplus24.com team

Date last updated: February 22, 2015

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