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Bed Wetting - Enuresis

Dr. Paritosh Tyagi


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Diagnosis

When bed-wetting continues to age 5 or 6 (or at any age if it is troublesome to the child) it is time to discuss it with the child’s doctor or with a doctor skilled in treating bed-wetting
  • Personal history of child.
  • Family history
  • Complete physical examination
  • Routine and microscopic examination of urine, stool examination, intra venous urogram.
  • Sometimes it is important to measure the child’s bladder size. This is often done at home with a measuring cup.

Treatment

  • Refrain child from taking beverages such as tea, milk or juices at least 2 hours before sleep.
  • Child should be habitually made to pass urine before retiring to bed.
  • Wake up the child at least twice in night to empty bladder.
  • Reassurance to both child and parents. Parents are advised never to criticize child. Do not reprimand your child else a feeling of guilt and shame will aggravate the problem.
  • Train the child to retain urine for longer period of time by persuading him to delay emptying bladder as long as possible.
  • Treating the specific cause that is underlying any disease such as nephropathy, diabetes, urinary tract infection, worms infestation etc.
  • It is also important to identify any constipation or encopresis (uncontrolled passing of stools). If one of these conditions is present, it should be treated first. The bed-wetting will often disappear when these conditions are treated.
  • Specific treatment
    • Chandraprabha Vati- 75-100 mg twice a day with water, after meals.
    • In case of urinary infections use – Varun Shigru kwath or dashmool kwath 10 –20 ml with equal quantity of water post meals.
    • Vang bhasm or trivang bhasm 75 mg twice a day for 5-7 days.

What can I do to Help?

  • Give your child support.
  • Do not blame or scold her for wetting the bed.
  • Do not force her to go to summer camp or spend the night at a friend’s house. She may be afraid she will wet the bed.
  • Help your child understand that the bedwetting is not her fault. It will get better.
  • Do not let brothers and sisters tease her. Tell them that she does not wet the bed on purpose.
  • Limit the amount of fluids your child drinks just before bed.
  • Have her use the bathroom before she gets in bed.
  • Don’t wake the child up in the middle of the night to go to the bathroom. This only keeps her from wetting the bed that night. Your child’s body and brain needs to learn how to wake her up on her own.
  • Don’t use pull-ups or diapers. This makes wetting easier for the child and sends the message that she is still "a baby" and wetting is okay.
  • Your child should help you change the sheets and change her own clothes as best she can. Make sure she is fully awake first. This teaches responsibility.
  • Be kind and patient. Do not get irritated or scold.

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