WHAT IS BEDWETTING?

Bedwetting, also known as nocturnal enuresis is a condition in which there is involuntary urination during sleep. It is normal till the age of 5 years but is a thing to worry about if the child passes urine in bed during sleep after the age at which bladder control usually occurs.
The child with this problem usually has increased production of urine at night, poor sleep arousal, and/or reduced bladder capacity and may also have increased frequency of urine in daytime also with incontinence of urine or urgency.

WHAT ARE THE TYPES OF NOCTURNAL ENURESIS?

• Primary

• Secondary

Primary nocturnal enuresis is when the child has not attained control over the bladder for long that is has not stayed dry for a prolonged period in bed.

Secondary nocturnal enuresis on the other hand is when the child or sometimes adults begin to pass urine in bed again during sleep after having stayed dry for a period of time.

WHAT ARE THE SYMPTOMS OF NOCTURNAL ENURESIS?

• Bedwetting in a child even after the age of five years.
• If the child starts bedwetting after staying dry for a long time.
• If the child has painful urination or the child feels that there is urgency in urine and he can’t control or hold urine.

WHAT ARE THE CAUSES OF NOCTURNAL ENURESIS?

1.  Delayed neurological development is a cause of nocturnal enuresis in which the child is delayed in developing or learning to stay dry and has no pathology.
   
   
2. Family history of the child with parents who suffered from enuresis has an increased risk for enuresis.
   
   
3. Hormonal imbalance of anti-diuretic hormone which regulated urine production also causes increased secretion of urine beyond a child’s bladder holding capacity.
   
   
4. Children with attention deficit hyperactive disorder also have an increased risk of bedwetting.
   
   
5. Caffeine also increases urine production.
   
   
6. Constipation may also cause involuntary urination as loaded bowel would exert pressure on the bladder causing enuresis.
   
   
7. Urinary tract infection may also cause enuresis.
   
   
8. Psychological issues also cause involuntary urination in children. Fear, anxiety, stress, death in the family, sexual abuse, scolding, bullying, and sadness may cause the child to pass urine in bed.
   
   
9. Type 1 diabetes mellitus causes polyuria and thus may cause involuntary urination in bed.
   
   
10. Heavy sleeping and improper toilet training also cause enuresis.

DIAGNOSIS OF NOCTURNAL ENURESIS

• Diagnosis is confirmed on the basis of the age of the child. If the child should be five years old or more to think about the illness.
• In a child 5-6 years of age, 2-3 episodes of bedwetting per month, and in a child above that age; one or more episodes of bedwetting would confirm the diagnosis.

TREATMENT OF NOCTURNAL ENURESIS

• Toilet training for the child should be done and the child should be guided to urinate frequently.
• Parents should be counseled about the management of the child.
• Homeopathic Medication would help the child.

MANAGEMENT OF NOCTURNAL ENURESIS

• Understand the cause and explain it to the parents
• Motivate the child with a positive attitude to stay dry
• Punishing the child will never help
• Making the child toilet trained would also help.
• Encourage the child to void urine on waking up at night, every 2 hours in the day, before going to bed, before leaving the house, and in school. At school also children should be encouraged to void urine frequently and empty the bladder completely.
• Holding of urine should be discouraged.
• Child should be taught to drink the optimum amount of water in 24 hours so that his body is well hydrated and the child is not too thirsty before bedtime.

HOMEOPATHIC MANAGEMENT OF NOCTURNAL ENURESIS

Homeopathy has many medicines which can help the child to get rid of bedwetting; sepia, kreosotum, staphasagria, graphites, sulphur, nature mur, tuberculinum, calcarea carb are a few medicines.
But along with medicines counseling of parent and child is very important to know the cause of the problem and also to help the child and parents to overcome the situation as behavioral modification can help the child to get relieved and have dry nights.
Homeopathic medicine along with counseling would help solve the problem along with removal of the underlying cause.

DO’S AND DON’TS

DO’S

• Motivate the child to stay positive for staying dry.
• Child should be toilet trained.
• Ask the child to urinate frequently.
• Ask child not to drink much liquid at once.
• Manage the liquid intake of the child.
• Wake the child up at night 2-3 times to urinate in the toilet.

DON’TS

• Don’t punish or scold the child.
• The child should not hold the urine for a longer time.