Enuresis symptoms are an indication of a medical problem that requires further evaluation by your doctor. It may be a simple case of bedwetting or it could be associated with a larger health issue such as diabetes, obstructive sleep apnea, or an intestinal problem.
Most children with enuresis outgrow the disorder by the time they reach their teenage years, with a spontaneous cure rate of about 12% to 15% per year. However, in a small number of cases, enuresis continues into adulthood and can interfere with normal function.
The most common symptom of enuresis is bedwetting at night. This occurs in about 5% to 10% of seven-year-olds and is usually caused by a hormonal problem with the production of antidiuretic hormone (ADH) that slows the kidney’s production of urine during sleep. In some people with enuresis, the amount of ADH produced by the body is reduced or eliminated altogether, making it impossible for them to stay dry at night.
Medications such as vasopressin are used to treat enuresis. These medications can help the brain send a message to the bladder that it is full and can make a person stop wetting the bed.
Bladder training and rewards are other enuresis treatments. Bladder training involves a series of trips to the bathroom timed at increasing intervals to strengthen the muscles that control urination and stretch the size of the bladder. Rewarding children with small rewards for urinating during the day or staying dry at night can help them learn to keep their bladders full longer and become more aware of their ability to control their urinary tract.
Some doctors and nurses prescribe bedwetting alarms, which are devices that have a bell or buzzer that goes off when the child begins to wet the bed. These can be very helpful for teens who have difficulty getting up in the morning or keeping their bladders empty until they get to the bathroom.
Other enuresis treatments include behavioral therapy and desmopressin. The latter is a medication that stimulates the bladder muscle to contract while reducing the number of contractions. The medication is effective in a small percentage of children and is often combined with other behavioral therapy and bladder training to improve the results.
Psychological and social factors are also important in determining the cause of enuresis. Stress can sometimes trigger the condition, as can being anxious or depressed. Other factors that can cause enuresis include chronic constipation or a neurological problem, such as spina bifida.
Eating habits are also an important part of a diagnosis of enuresis. Foods such as caffeine and dairy products can increase enuresis. Avoiding caffeine, dairy products, or fatty foods can also prevent it.
Your doctor will likely recommend a urinalysis to rule out a urinary tract infection or other health problems. In some cases, a X-ray or ultrasound of the kidneys and bladder is needed.
If your child has enuresis, your doctor will most likely refer you to a urologist for further testing. A urologist is an expert in the field of urology and will be able to determine the underlying cause and develop a treatment plan.
