Bed wetting also known as nocturnal enuresis is a condition in which there is involuntary urination during sleep. It is normal till age of 5 years but is a thing to worry if the child passes urine in bed during sleep after the age at which bladder control usually occurs.
The child with this problem usually have increases 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.
TYPES OF NOCTURNAL ENURESIS:
- Primary
- Secondary
Primary nocturnal enuresis is when the child has not attained control over bladder for long that is has not stayed dry for 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.
CAUSES:
- Delayed neurological development is a cause of nocturnal enuresis in which the child is delayed in developing or learning to stay dry and have no pathology.
- Family history of the child with parents who suffered from enuresis have increased risk to have enuresis.
- Hormonal imbalance of anti diuretic hormone which regulated urine production also cause increased secretion of urine beyond child’s bladder holding capacity.
- Children with attention deficit hyperactive disorder also have increased risk of bed wetting.
- Caffeine also increase urine production.
- Constipation may also cause involuntary urination as loaded bowel would exert pressure on bladder causing enuresis.
- Urinary tract infection may also cause enuresis.
- Psychological issues also cause involuntary urination in child. Fear, anxiety, stress, death in family, sexual abuse, scolding, bullying, sadness may cause child to pass urine in bed.
- Type 1 diabetes mellitus cause polyuria thus may cause involuntary urination in bed.
- Heavy sleeping and improper toilet training also cause enuresis.
MANAGEMENT:
- Understand the cause and explain it to the parents
- Motivate the child with 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 day, before going to bed, before leaving the house and in school. At school also child should be encouraged to void urine frequently and empty the bladder completely.
- Holding of urine should be discouraged.
- Child should be taught to drink optimum amount of water in 24 hours so that his body is well hydrated so that the child is not too thirsty before bedtime.
HOMOEOPATHY AND NOCTURNAL ENURESIS
Homeopathy has many medicines which can help the child to get rid of bed wetting; sepia, kreosotum, staphasagria, graphites, sulphur, nature mur, tuberculinum, calcarea carb are 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 solving the problem along with removal of the underlying cause.
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