Know more about Nocturnal Enuresis

Nocturnal enuresis commonly called as bedwetting is a common problem seen in many children. This condition arises when you child is unable to control urination during sleep.  Mostly children with nocturnal enuresis may have excessive nocturnal urine production or reduce bladder capacity. Urinary urgency is seen in children during daytime and this condition is also called as incontinence of urine.

Types of Nocturnal Enuresis

The common types of nocturnal enuresis include:

1. Primary nocturnal enuresis

Primary nocturnal enuresis is the recurrent involuntary passage of urine while the child is asleep. It is mostly seen in children 5 years or older who were not able to achieve consistent nighttime dryness.  Primary nocturnal enuresis is further classified into two categories i.e., night time urgency or day time urgency or daytime wetting.

Primary nocturnal enuresis most often requires developmental delay which can be resolved in time.

2. Secondary nocturnal enuresis

Secondary nocturnal enuresis is an involuntary passage of urine during sleep by your child who does not have a history of bedwetting in past. Mostly children who had been dry for at least six months and face involuntary passage of urine are covered under secondary nocturnal enuresis.

Secondary nocturnal enuresis generally requires medical attention as the child regresses after a period of continence. This condition may require proper diagnosis as it is usually due to the urinary infection.

Risk factors of Nocturnal Enuresis

There are a number of factors that are responsible for persistent nocturnal enuresis. The most common risk factors include:

1. Genetic predisposition

According to a research study, children with a family history of primary nocturnal enuresis have a higher risk of small bladder capacity or outflow obstruction than controls.

2. Encopresis

23% of the nocturnal enuresis cases are generally associated with encopresis and daytime incontinence.

3. Developmental delay

Developmental delay is mostly associated with nocturnal enuresis. Children with Down’s syndrome are at high risk of nocturnal enuresis. The other factors like premature delivery, behavioral disorder such as hyperactivity or attention deficit can also lead to nocturnal enuresis.

4. Neurological disorder

Neurological disorders like cerebral palsy and spina bifida can also increase the risk of nocturnal enuresis.

5. Physical problems

Physical problems usually increase the risk of nocturnal enuresis. Physical problems may lead to daytime enuresis. Nocturnal enuresis is generally associated with urinary incontinence, bowel problems and sleep disordered breathing.

6. Drinks containing methylxanthines

The food and drink that your child consumes on a daily basis also have an impact on the nocturnal enuresis. Drink containing high amount of methylxanthines like caffeine and energy drinks can aggravate the situation due to their diuretic action.

Chocolates, cola, coffee and tea can increase the incidence of nocturnal enuresis in most of the children.

7. Stress

Stress during childhood is one of the common factors that may lead to enuresis in most of the children. Psychological problems are mostly seen in older children resulting in enuresis.

How Does the Body control Bedwetting?

There are two ways through which the body can control bedwetting.

• While sleeping, certain anti-diuretic hormones called arginine vasopressin (AVP) are produced in your child’s body. AVP hormone usually reduces the urine production in your child’s body. During sunset each day, human body starts releasing arginine vasopressin (AVP) and thus, kidney urine output decreases. Thus the bladder is less likely to become full during the night.
• As the child grows the nerves around the bladder will develop more, it causes the child to wake up from sleep and use the restroom.

Try monitoring your child to diagnose the type of enuresis he/she is suffering with. Early diagnosis can help in better treatment of your child.