Enuresis is repetitive voiding of urine, either during the day or night, at inappropriate places. This state of affairs is normal in infancy.
Most children achieve bladder control by the age of three years. By the age of 5 years, there are still about 7% of children who wet their bed. Clinically , enuresis is diagnosed only after 5 years of age.
Enuresis can be two type
- Primary type, where bladder control has never been achieved.
- Secondary type, where enuresis emerges after a period of bladder control (at least one year). The majority (about 80%) of children with enuresis have nocturnal bed wetting only.
- Emotional disturbances
- Sibling rivalry
- Mental retardation
- Childhood schizophrenia
- Autistic disorder
- Anxiety disorder
- Spina biﬁda
- Neurogenic bladder
- Urinary tract infection
- Diabetes mellitus
- Seizure disorder
- Worm infestation
- A hormone imbalance. During childhood, some kids don’t produce enough anti-diuretic hormone (ADH) to slow nighttime urine production
- Stress and anxiety. Stressful events — such as becoming a big brother or sister, starting a new school, or sleeping away from home, conflict between parents— may trigger bed-wetting.
- Family history. If one or both of a child’s parents wet the bed as children, their child has a significant chance of wetting the bed, too.
- Attention-deficit/hyperactivity disorder (ADHD). Bed-wetting is more common in children who have ADHD.
- Restriction of ﬂuid intake after 8 PM, in nocturnal enuresis.
- Bladder training during daytime, aimed at increasing the holding-time of bladder. This is carried out in a step-by-step manner using positive reinforcements.
- Interruption of sleep before the expected time of bed wetting. The child should be fully woken up and made aware of passing of urine.
- Conditioning devices, which cause an alarm to sound as soon as the voided urine touches the bedsheet. It is important to check the child’s hearing before starting treatment. The alarm causes inhibition of further micturition and the child awakens. If properly used, it is an effective method of therapy.
- Supportive psychotherapy for the child, parents and the whole family is often needed
The family environment should be warm and understanding. The emotional disturbances of the child should not be ignored and should be dealt with at the earliest.
6.Avoid beverages and foods with caffeine