Kid is wetting the bed at night? This condition is called nocturnal enuresis. Nocturnal enuresis means bed wetting only in the nighttime. It is also known as involuntary urination, as a kid might pee and not even know the same in their sleep. The person has no control over his/her bladder. Bed wetting does not just occur in small kids but may happen with children of 10 years of age. Doctors have to find the exact factor behind bed wetting to provide appropriate treatment. To know more about this problem, Onlymyhealth editorial team spoke to Dr Charu Kalra, Consultant - Pediatrics, Max Multi Speciality Centre, Noida, about the symptoms causes and treatment of nocturnal enuresis.
Nocturnal enuresis causes
There are many reasons behind this conditions, both medical as well as non-medical. According to Dr. Charu Kalra, here are the major causes of nocturnal enuresis:
1. Developmental delay
In almost 90% of the cases, it is a developmental delay in kids so they over come it. Not all the kids know that they have to get up and go to the washroom. Some require proper training and they take a little more time to adapt. It is not related to any emotional stress or physical issues.
2. Urinary tract infection (UTI)
Only in 10% of the cases it is a medical cause. It is mostly because of Urinary Tract Infection (UTI). In UTI, there is a need to pee frequently so wetting while sleeping at night also becomes an impact of that.
Not just bladders, even bowels can also trigger urinating. It might sound surprising but children who pee on their bed at night might also be suffering from constipation. It is important to visit the doctor in such cases.
Also read: Toddler Bed-Wetting Problems
4. Structural deformities
Structural deformities or abnormalities may give birth to urinary problems, thus leading to bed wetting at night. So, this can be one of the rare causes of nocturnal enuresis.
5. Emotional or sexual abuse
Emotional and sexual abuse can make you nervous, traumatized and weak at by no t the same time. An emotional or physical abuse during childhood can have a very negative impact on our mind and body. This is a very rare cause but goes undiagnosed several times.
6. Attention deficit hyperactivity disorder
Attention deficit hyperactivity disorder (ADHD) is a condition of difficulty in paying attention and impulsiveness. This disorder is most commonly seen in kids and ADHD can make someone go through nocturnal enuresis during childhood.
Nocturnal enuresis symptoms
The most common symptom is that the child would wet the bed during nighttime, which is not expected of his age. It is an involuntary passing of urine and the child might even know about this. That is the only primary symptom of bed wetting. But, secondary symptoms would lead us to a proper diagnosis such as speech delay and normal behaviour in ADHD. While burning sensation or pain in UTI, can also be sign to get it treated. Therefore, these are the symptoms which might depend upon the diseased person. If bed wetting at night continues even after 5 years of age, It might be nocturnal enuresis and should be treated by a doctor immediately.
What is the treatment for bed wetting?
Positive reinforcement is very important for the kids in this condition. The parents are adviced to try behavioural therapy. From the age a 5, a consultation is suggested and the pediatrician starts manage the child. Dr. Charu said, "We try to rule out any other causes like UTI, constipation or any other secondary features that are present. We advice the parents to give a small gift to the child if he/she hasn't urinated in the bed that night. This will motivate them and add positivity towards this habit. The parents should surely refrain from making the kid feel awakward or embarrassed. Don't indulge into negative reinforcement as this can make the situation even worse. Around 70-75% kids get fine only with this way of treatment."
In a few cases, there should be restriction of fluids, just 2-3 hours before bed. Before sleeping, don't give anything to drink to your child after 5 years of age. When the kid reaches the age of 10 years, that is when it becomes a huge concern for the family as well as the doctors. This requires a lot of investigations and tests in terms of many secondary causes of bed wetting. Medication is a line of testament but that comes in the picture very late. The first thing that the doctors also do is behavioural therapy. The treatment or medicines also depends on the underlying cause of nocturnal enuresis.
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