Soggy sheets and pajamas — and an embarrassed child — are a familiar scene in many homes. Bedwetting is the unintentional (involuntary) discharge of urine during the night.

Dr kajal Verma -Homoeopathy physician

Bedwetting, also called enuresis, is one habit disorder that causes trauma, pain and disturbance to all concerned. It is involuntary urination while asleep after the age at which bladder control would normally be anticipated. It is common in children, and can affect adolescents too. Studies have shown that boys are more likely to wet their beds than girls. This cause embarrassment and stress for children and their families.

Bedwetting is the most common pediatric health issue. Studies show that parents become worried too quickly because they expect children to stay dry too early. Most girls can stay dry by age six and most boys stay dry by age seven. By ten years old, 95% of children are dry at night. Studies place adult bedwetting rates at 0.5% to 2.3%. As per recent research , if both parents of an individual had bed wetting problems themselves then chance of their child suffering from bed wetting is as high as 77 percent.

For a diagnosis of enuresis

wetting must occur twice a week for at least three months with no underlying physiological cause.
Enuresis, both nighttime (nocturnal) and daytime (diurnal), at age five affects 7% of boys and 3% of girls. By age 10, it affects 3% of boys and 2% of girls; only 1% of adolescents experience enuresis.

Types

The condition is divided into two types :
primary nocturnal enuresis (PNE) and secondary nocturnal enuresis (SNE).

Primary nocturnal enuresis (PNE)

Primary nocturnal enuresis (PNE) is the most common form of bedwetting. Bedwetting counts as a disorder once a child is old enough to stay dry, but continues either to average at least two wet nights a week with no long periods of dryness or to not sleep dry without being taken to the toilet by another person. Medical guidelines vary on when a child is old enough to stay dry. Common medical definitions allow doctors to diagnose PNE beginning at between 4 to 5 years old. It defines PNE as, “Persistent bedwetting in the absence of any urologic, medical or neurological anomaly in a child beyond the age when over 75% of children are normally dry.”

Secondary nocturnal enuresis (SNE)

Secondary nocturnal enuresis occurs after a patient goes through an extended period of dryness at night (roughly 6 months or more) and then reverts to nighttime wetting. Secondary enuresis can be caused by emotional stress or a medical condition, such as a bladder infection, diabetes and so on.

What are the causes

The exact cause of bed wetting is not known. It is believed to be due to:

Common causes

Neurological developmental delay: This is the most common cause. Most bedwetting children are simply delayed in developing the ability to stay dry and have no other developmental issues.
Genetics: Bedwetting has a strong genetic component. Children whose parents were not enuretic have only a 15% incidence of bedwetting. When one or both parents were bedwetters, the rates jump to 44% and 77% respectively. Genetic research shows that bedwetting is associated with the genes on chromosomes 13q and 12q (possibly 5 and 22 also).

Less common causes

Small bladder: Your child’s bladder may not be developed enough to hold urine produced during the night.Inability to recognize a full bladder: If the nerves that control the bladder are slow to mature, a full bladder may not rouse your child from sleep — especially if your child is a deep sleeper.
Psychological causes: Stressful events, such as becoming a big brother or sister, starting a new school, or sleeping away from home, may trigger bedwetting. Psychological issues (e.g., death in the family, sexual abuse, extreme bullying) are established as a cause of secondary nocturnal enuresis (a return to bedwetting), but are very rarely a cause of primary nocturnal enuresis type bedwetting.

Urinary tract infection: A urinary tract infection can make it difficult for your child to control urination. Signs and symptoms may include bedwetting, daytime accidents, frequent urination and pain during urination

.Sleep apnea: Sometimes bedwetting or enuresis is a sign of obstructive sleep apnea, a condition in which the child’s breathing is interrupted during sleep — often because of inflamed or enlarged tonsils or adenoids.

Other signs and symptoms may include snoring, frequent ear and sinus infections, sore throat, and daytime drowsiness

.Chronic constipation: A lack of regular bowel movements may lead to reduced bladder capacity, which can cause bedwetting at night.

Anatomical defect: Rarely, bedwetting or enuresis is related to a defect in the child’s neurological system or urinary system.

A hormone imbalance: During childhood, some kids don’t produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.

Diabetes: For a child who’s usually dry at night, bedwetting may be the first sign of diabetes. Other signs and symptoms may include passing large amounts of urine at once, increased thirst, fatigue and weight loss in spite of a good appetite.

Sound sleeping: Many parents note that their child who wets the bed is a deep sleeper. These children usually wet the bed less frequently as their sleep patterns mature.

Symptoms

Bedwetting or enuresis is not a disease, so it has no symptoms. For a child who has never had nighttime bladder control for more than 3 months, overcoming this problem is usually a matter of normal growth and development and this can be taken care of with appropriate homeopathic treatment.

If a child has other symptoms, such as crying or complaining of pain when urinating, sudden strong urges to urinate, or increased thirst, bedwetting may be a symptom of some other medical condition. A child with any of these symptoms should be evaluated by a doctor.

How is bedwetting diagnosed

Detailed history of bedwetting episodes and normal urination, type and time of food and liquid intake and sleeping times help the doctor to diagnose the condition of bedwetting or enuresis. Physical examination is done to check any physical causes.Urine analysis is done to rule out infection or diabetes.X-ray or ultrasound of kidney and bladder are done only if some other physical problem is suspected.

Teenager or adult bedwetting or enuresis

Teen / adult bedwetting or enuresis is a problem that most of the patients are embarrassed to admit or even talk about. It is a problem that most teens would rather keep to themselves. In the process, they might continue to feel as insecure knowing that they are experiencing something that most kids their age would find funny and quite embarrassing. But there are some things that teenagers who frequently experience bedwetting should know.

For many teenagers and adults who suffer from nocturnal enuresis the very act of going to sleep is one of the most stressful parts of the day. This ongoing stress and subsequent lack of sleep can be detrimental to one’s health over time. Ironically, this stress and fatigue can actually be a contributor to bedwetting of adults and could easily lead into a vicious cycle of worry and mental anguish which only gets worse without treatment or proper care.

Some teenagers may even dream in their sleep going into the toilet that can become so realistic that they already wet their bed while dreaming of peeing in the bathroom. It is also common for bed wetters not to experience it when they sleep at a friend’s house. The reason is that they usually get anxious about wetting their bed that they end up not sleeping as soundly and as deep as they do at home.

 

Home care

Help your child understand that controlling his or her bladder will get easier as your child gets older.

Here are some tips that may help your child:

Give your child most of his or her fluids in the morning and afternoon .

Limit caffeine from chocolate or colas, especially at night.

Have your child use the toilet before he or she goes to bed.

Praise your child for dry nights. Instead of making your child feel ashamed and embarrassed, parents should try to encourage and express confidence in their children that they will eventually out grow hi this condition. Positive reinforcement would usually work better in trying to stop bed wetting in children.

Homoeopathic approach

Based on the “Constitutional Approach”, homeopathy treats the medical condition within its root level, which enhances the bedwetting child’s resistance.

Homoeo medicines prevent unwanted contractions of the bladder, thus suppressing involuntary urination. Also, homeopathic remedies reduce anxiety which is known to be among one of the potential reasons for secondary nocturnal enuresis, and naturally treat bed wetting without distracting the endocrine system.

Aside from the aforementioned benefits, homeopathic pills are sweeter in taste, which makes them much more preferred and accepted by kids.

The following are among the most effective remedies to treat a child with Nocturnal Enuresis:

Equisetum
Causticum
Kreosote
Sepia
Argentum nitricum etc

Parents must remember that bed-wetting is not the child’s fault. Instead, they should be treated with utmost understanding and consideration. Treatment can be successfully achieved with the help and support of the child’s parents and family.

Homeopathic remedies are safe for infants and children. Research shows that children respond to the the treatment much faster than the adults. The reason is that, most of the time children come under homeopathic treatment without diseases getting too chronic or complicated. Children have a very strong tendency to grow out of the problem; all they need is stimulation for the immune system, which homeopathy does quiet effectively.

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