Bed wetting- a common problem

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Involuntary discharge of urine in sleep at night, also called “Nocturnal Enuresis” is common until 5 years of age. It resolves spontaneously and affects only about 1% of adults. Enuresis is a symptom and not a specific diagnosis.

Normally the contents of the urinary bladder are voided when it is sufficiently distended to stimulate the urge to urinate. The urge can be held off for a long time in adults by voluntarily controlling the urinary sphincter. In infants and children under 3 years urinary incontinence is normal as the nerves which control the external sphincter are not developed completely. Once sphincter control is established the child learns to hold off urinating till the right time and moment.
Nocturnal Enuresis in children commonly called Bedwetting may have a genetic basis. It is more common in those children whose parents and siblings were bed-wetters and also in identical twins. Possible causes include a smaller than normal bladder capacity, or higher rate of production of urine at night or failure to awaken from sleep in response to a full bladder. A child over 5 years of age is considered Enuretic, if there are 2 or more episodes of bedwetting per month for atleast 3 months. Most children with urinary incontinence do not have any anatomic or neurological disease causing their bed-wetting and the physical findings are usually normal. Most cases of bed-wetting resolve by the age of 5 years, if it persists the cause should be further investigated.

Secondary Enuresis occurs when a child who has been continent develops bed wetting. This usually results from emotional stress like being bullied by peers, birth of a sibling, beginning school, fear etc. In such cases the problem should be addressed and some guidance and counselling for the child helps. Physical problems like a urinary tract infection can trigger incontinence and should be suspected in children with secondary enuresis and if the child develops a fever. Urine tests and cultures show the presence of bacteria in such instances.

Since most cases of bed wetting is caused by a developmental delay, most children will outgrow it. When they fail to do so, they may suffer from emotional stress and psychological embarassment. It is important for the parents to not punish or shame the child which only aggravates the problem further and reduces self esteem.


Treatment

Bed-wetting alarms teach the child to respond to a full bladder by waking up and using the restroom. It works by altering behaviour and bringing awareness about a full bladder. Other options include hormonal therapies, and surgical procedures like urethral enlargements.
Homeopathy has more than hundred remedies for the treatment of bedwetting. It requires that one remedy, which is most similar to the patient’s complaint be given to relieve the symptoms and treat the condition. Remedies like Belladonna, Kreosotum, Sepia, Causticum, Lycopodium and Equisetum come into play in the treatment of enuresis. I will  go through the case in detail before I select the right remedy for your child. We  can also help with bed wetting in adults.