Bed wetting or Nocturnal enuresis- Definition, Causes and Treatment

Definition

Enuresis is the clinical term for bedwetting. It is the involuntary urination during sleep after the age four or five when a person should be able to control the bladder. Infants and children’s will do unintentional urination, it is more normal for them.  Many children’s achieve daytime control but not in the night time. The bladder control varies depending upon age. Some parents expect dryness at the early age. When the child is capable of holding the bladder but urinates unfortunately while sleeping is called nocturnal enuresis.

Bedwetting

Prevalence

Enuresis is one of the most prevalent and frustrating disorders of childhood. A child expected to sleep dry at night time without making wetting the bed between the ages of 2 and 4. However, at age four, 25% of children still wet the bed; at age five, 20%; at age six, 15%; at age ten, 8%; at age fourteen, 4%; and at age eighteen and over, 2% of the population are still bed wetter’s.

Types

There are two main types of nocturnal enuresis such as

Primary bedwetting: Bedwetting since from the early stages of the child. The child not yet achieved nighttime dryness over a period of six consecutive months.

Secondary bedwetting: bed wetting that begins after the child has been dry at night for a significant period of time, at least 6 months.

Risk factors

Risk factors for the cause of enuresis include:

  • Family history plays a role in enuresis
  • Chronic constipation
  • Sleep apnea
  • Urinary tract infection
  • Intake of excessive water content foods 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
  • Sexual abuse

Causes

Doctors do not know the actual cause for nocturnal enuresis. But there are various developmental conditions include:

Hormonal problem: 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 results in the increased production of urine when the person is sleeping.

Genetics: Teens with enuresis often have a Parent who had the same problem at about the same age. scientifically identified the specific genes that cause enuresis.

Sleep problems: sometimes deep sleep may cause enuresis that they don’t wake up when they want to pee. Sometimes bedwetting is the sign of obstructive sleep apnea.

Bladder problem: Your child may have a small bladder or not developed properly. This cannot be able to hold urine which is produced during the night.

Caffeine: Caffeine can cause a person to urinate more.

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 enuresis. But it is rare.

Psychological problems: Some doctors believe that stress or tension can be associated with enuresis.

Symptoms

Many people will wet their bed only at night. They will not have other symptoms than bed wetting. But some physiological problems with nervous system or kidney may cause the signs and symptoms.

  • Bedwetting during the day
  • Frequency, urgency or burning during urination
  • Dribbling, straining or other unusual symptoms of urination
  • Being unable to control bowel movements
  • Constipation

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

Complications

Bedwetting can create some issues for your child including

  • A person cannot go to trip or stay outside home for social activities such as sleepover and camp
  • Rashes may occur in the bottom or in genital area due to sleep in wet underwear for  a long time
  • Bedwetting can lead a person to feel low self-esteem, guilt, and embarrassment

Diagnosis and test

Your doctor may ask questions about your symptoms, your past health history, family history and other medical problems. A doctor may recommend the following to identify the cause of bed wetting.

  • Urine test to find any signs of an infection or diabetes
  • Physical exam
  • Discuss family history, symptoms, fluid intake, bowel and bladder habits, and problems associated with bedwetting
  • Imaging tests such as X-Ray or MRI of kidney or bladder to look at the structure of urinary tract

Treatment and medications

Your doctor can do several things to treat bedwetting based on what caused it.  The most often treatment for enuresis is behavioral modifications.

Bedwetting alarms: To treat bed wetting in teens, various types of bedwetting alarms are available. Most of the persons respond to the alarms and make them go toilet. These alarms will go on when the person begins to wet on the bed. By this alarm, a person can sleep without wetting the bed too much. If it’s been doing for years, automatically you can train yourself to wake up or to hold your urine until morning.

Bedwetting alarm

Manage what you eat and drink before bed: People who with enuresis can manage their food and drinks before sleeping. By going toilet before going bedtime can reduce the bed wetting. Avoid certain foods in the evening which can irritate the bladder include such as tea, coffee, chocolate, sodas and other carbonated beverages containing caffeine.

Imagine yourself dry: Positive imagery can make you dry during the night, where you think about waking up dry before you go to sleep, can help some people stop bedwetting. Some people find that rewarding themselves for waking up dry also works.

Acutreatment: water imbalance can also cause the bed wetting. It can be balanced by doing acupressure treatment. Massaging the pressure points in the body that belongs to water balance points are shown in the figure.

Pressure points for bed wetting

Medical treatment

Bedwetting that 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.

Prevention

  • Parents should encourage child by being positively and should make them understand how the bedwetting will affect his or her social life
  • Wake up your child several times to go to toilet for urination
  • Encourage your child to urinate before bedtime and several times in a day, that makes your child as routine habit
  • Avoid beverages and food that contain caffeine before bedtime

 

 

 

 

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41 comments

  1. pls my first son is 8 years plus and he pee at night while the second son is 6 year plus don’t pee at night though i have some conditions when i was small i stop pee when i was above 10- 11 years and happened to have the same blood group with my first son…do you think is genetic although he was very sick when he was small(0-7 months old)..thanks Paul

  2. i have the same blood group with my son and he 8 years plus he pee in the night..i stop pee when i was 10 plus

  3. I think bed wetting is not often a sickness, I was a chief bed wetter I used to peee on bed 2x from my age 1 to age 15 and it gave me a lot of concern, how I stopped my own is very simple 1, some times I will not drink water after eating in the night, 2, if I drink water or not , I must make sure that I forced my self to pee like 5 or more times before bedtime. 3 I do go to bed very late so that I will easy my self very well, that was how I stopped peeing on bed and I thank God for that idea.

  4. my first child who is seven years old does not bed wet and he doesn’t wake up up to use the toilet at night please I want to know is this condition normal doc?

    • Mostly it will be a normal condition. but check once with a doctor to confirm whether it is a normal or due to some other problems which is mentioned in the causes section in the post.

  5. my second son 3yrs bedwet, if wake him up to pee by 1am he will still bedwet. he is playful, in the day if he is playing he won’t visit the toilet until the urine is almost coming out. what should I do

  6. my brother is 20 years old and still bedwets. how can I help him quit it

  7. Your NameAbdullah Taibat

    my son of 11year he use to pee, he latter spot it but now I know why he have pee again pls Dr help me on what to do. thanks

  8. pls am 25years now and a graduate. at times I pee on the bed. it has happened before my boyfriend. pls what should i do. I want to drink poison. it happened to my elder sister. and in my sleep I will dream of where am essing myself and when I woke up, my bed will be wet. pls I need help.

    • First, Manage your food and drinking habits before your bedtime. use bed wet alarms, these alarms will go on when the person begins to wet on the bed. By this alarm, you can sleep without wetting the bed too much. If it’s been doing for years, automatically you can train yourself to wake up or to hold your urine until morning.

  9. how does constipation cause bed wetting
    Good morning

  10. Thanks for your good job. Are the medicine mentioned here are “on the canter” drugs. I mean if I can just write it out and buy without doctors paper????

  11. I am 21 but I can’t Control my bladder

  12. my daughter is sixteen she pee onbed almost all night

  13. what could cause the urge to urinate after urination

  14. I am 30 year old but i still betwed i do not no weather I have a small bladder or other infection. pls. sir can i take the recommended drugs for bladder enlargement.?

  15. An adult who went for spine surgery and at the end of the day can no longer control his urine, leaving her in wearing of pampers. what please can be the solution. Best regards

  16. I want to know why adults are bedwetting

    • When there is a physical impediment or neurological disconnect in the sphincter muscles of the bladder, urination can become problematic or mistimed.
      Treatment for adult bedwetting is 1) bed-wetting alarm system, 2) Sacral nerve stimulation, 3) Sacral nerve stimulation, and 4) Detrusor myectomy.

  17. I had this experience from early age to 13years, is there a possibility that it will pass on to my offspring?

  18. why is still happening in adults doc and how can we treat it

  19. Your NameKhalid

    my son aged 14 is pee at night. Doctor said the reason is that her mother had not took folic acid during pregnancy.

  20. my children stop bed wetting before they even stop breastfeeding at about one year is this ok. Can that be a sign of impotency

  21. But if the bed wetting is spiritiual, what can we do ? bcos medicine can’t work

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