Bed-wetting -Nocturnal enuresis

Abstract

Bed-wetting — also called nighttime incontinence or nocturnal enuresis — is involuntary urination while asleep after the age at which staying dry at night can be reasonably expected.Soggy sheets and pajamas — and an embarrassed child — are a familiar scene in many homes. But don't despair. Bed-wetting isn't a sign of toilet training gone bad. It's often just a normal part of a child's development. Nocturnal enuresis, also called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress.

Full text

Bed-wetting - Nocturnal enuresis.
Author
Hayk S. Arakelyan. Full Professor in Medicine,
Doctor of Medical Sciences, Ph.D , Grand Ph.D .
Senior Expert of Interactive Clinical Pharmacology , Drug Safety,
Treatment Tactics, General Medicine and Clinical Research.
“Natural forces within us are
the true healers of disease.”
“ Hippocrates”
Introduction.
Bed-wetting — also called nighttime incontinence or nocturnal enuresis — is
involuntary urination while asleep after the age at which staying dry at night can be
reasonably expected.Soggy sheets and pajamas — and an embarrassed child — are
a familiar scene in many homes. But don't despair. Bed-wetting isn't a sign of toilet
training gone bad. It's often just a normal part of a child's development. Nocturnal
enuresis, also called bedwetting, is involuntary urination while asleep after the
age at which bladder control usually begins. Bedwetting in children and adults can
result in emotional stress.
Causes and Risk factors of Bed-wetting.
No one knows for sure what causes bed-wetting, but various factors may play a
role:
A small bladder. Your child's bladder may not be developed enough to hold
urine produced during the night.
Inability to recognize a full bladder. If the nerves that control the bladder

are slow to mature, a full bladder may not wake your child — especially if
your child is a deep sleeper.
A hormone imbalance. During childhood, some kids don't produce enough
anti-diuretic hormone (ADH) to slow nighttime urine production.
Urinary tract infection. This infection can make it difficult for your child to
control urination. Signs and symptoms may include bed-wetting, daytime
accidents, frequent urination, red or pink urine, and pain during urination.
Sleep apnea. Sometimes bed-wetting is a sign of obstructive sleep apnea, a
condition in which the child's breathing is interrupted during sleep — often
due to inflamed or enlarged tonsils or adenoids. Other signs and symptoms
may include snoring and daytime drowsiness.
Diabetes. For a child who's usually dry at night, bed-wetting may be the first sign
of diabetes. Other signs and symptoms may include passing large amounts of urine
at once, increased thirst, fatigue and weight loss in spite of a good appetite.
Chronic constipation. The same muscles are used to control urine and stool
elimination. When constipation is long term, these muscles can become
dysfunctional and contribute to bed-wetting at night.
A structural problem in the urinary tract or nervous system. Rarely, bed-
wetting is related to a defect in the child's neurological system or urinary
system.
Bed-wetting can affect anyone, but it's twice as common in boys as in girls.
Several factors have been associated with an increased risk of bed-wetting,
including:
Stress and anxiety. Stressful events — such as becoming a big brother or
sister, starting a new school, or sleeping away from home — 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.
Symptoms of Bed-wetting.
Most kids are fully toilet trained by age 5, but there's really no target date for
developing complete bladder control. Between the ages of 5 and 7, bed-wetting

remains a problem for some children. After 7 years of age, a small number of
children still wet the bed. Although frustrating, bed-wetting without a physical
cause doesn't pose any health risks. However, bed-wetting can create some
issues for your child, including:
Guilt and embarrassment, which can lead to low self-esteem
Loss of opportunities for social activities, such as sleepovers and camp
Rashes on the child's bottom and genital area — especially if your child
sleeps in wet underwear.
If you have any questions concerning “Bed-wetting - Nocturnal enuresis”,
interactive clinical pharmacology , or any other questions, please inform
me .
Prof. Hayk S. Arakelyan