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Bed Wetting - Enuresis

Dr. Paritosh Tyagi

Ayurveda is not a science dealing only with drugs and more a “way of life”. Thus ayurveda forms a very good mode of treatment for children’s ailments.

Most children learn how to stay dry during the day before they are able to stay dry at night. Millions of kids wet the bed long after they feel that they should be dry.

Similarly many parents feel that their children bed wet because of some defect in their parenting. And of course relatives and friends with same age group children heighten this feeling.

Enuresis is a condition in which children empty the bladder involuntarily and wet the bed at an age beyond which sphincter control is normally developed.

An occasional lapse is of no concern but when it occurs frequently it is termed as enuresis.

Usually after the age of two a child stops bed-wetting in daytime and tries and tells his mother on an urge to urinate. After the age of five a child is supposed to completely stop bed-wetting.

Enuresis is prevalent in almost one-fourth of children and occurs usually more in boys than girls.

Types

Enuresis could be primary or secondary.

Delay in maturation of neurological control of sphincters causes primary nocturnal enuresis. These types of children never remain dry.

Sphincter control develops at normal age in secondary enuresis and the child remains dry for several months before he starts bed wetting again. This could be due to any reason- either new psychological stress such as a divorce, a move, or a death in the family. It might be something physical: the onset of a urinary tract infection or diabetes, for example. It might be a situational change, such as altered eating, drinking, or sleeping habits.

Secondary enuresis denotes a child’s desire to gain attention, care and love.

Causes

  • Stress, tension, insecurity, craving for love and attention, bully on school by teachers and colleagues, fear of going to school etc. also make a child bed wet.
  • Emotional stress, poor self-esteem, or emotional immaturity.
  • Excessively enthusiastic attempts of toilet training by parents or no training at all.
  • Behavioral disturbances observed by child as a result of shame or guilt.
  • There could be any medical problem like: juvenile diabetes mellitus, sleep apnea, threadworm infection, epilepsy, psychiatric disorder, urinary tract infection, calculi or even constipation.
  • There is an imbalance of the bladder muscles. (For example, the muscle that contract to squeeze the urine out is stronger, at moments, than the sphincter muscle that holds the urine in).
  • They have bladders that are a little too small to hold the normal amount of urine.
  • They make more urine than their normal-size bladders can hold, for several reasons:
    • They may drink too much. Drinking in the two hours before bed increases nighttime urine production.
    • They may be consuming a diuretic medication, a substance that directly increases urine output. They may also consume diuretic beverages or foods like caffeinated cola drinks or chocolate.
    • They may make more urine in response to a chronic disease, such as diabetes or a chronic urinary tract infection.
    In any case, children who wet the bed have two things in common. First, they need to urinate at night. Not all children do. During the first months of life, babies urinate around-the-clock. Most adults, however, don’t need to urinate at night (although a small percentage of the population will need to urinate at night throughout life). Sometimes in middle childhood, most kids make the transition from urinating around-the-clock to only urinating during waking hours. The second thing children who wet the bed have in common is that they don’t wake up when they need to urinate. When infants need to urinate, there is no signal that goes from the bladder to the brain to wake them up. Children who wet the bed are dramatically more difficult to wake up than others.

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