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Causes of Bedwetting
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There are several factors which play a role in nocturnal enuresis. In each
child the causes may be different, and there is usually more than one factor
involved. What is clear is that the child has no control over the
bedwetting.
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The most common cause is a late maturation of the central nervous system
which results in the brain not responding to the sensation of a full bladder
during sleep. The bladder then spontaneously empties. This
delayed maturity is often something that is inherited. 70% of all
enuretic children have at least one relative who was enuretic as a child.
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Many bedwetters are very deep sleepers. This is only because deep sleep is a normal
childhood pattern. It does not cause the bedwetting, but can
make the the treatment more difficult.
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Some bedwetters have a smaller than usual functional bladder capacity, so that their
bladders empty sooner than those of other children, or contract in an
uncontrolled fashion. To help with this
problem, encourage sufficient fluids during the day (6-7 cups is about
average), and good toiletting habits of
voiding urine at regular intervals, which should be about two hourly.
Most children with this problem have daytime incontinence as well, and
should see a Doctor for assessment. There are effective drug
treatments available for unstable bladder contractions, which can be
effective alone, or in conjunction with alarm therapy.
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The hormone Antidiuretic Hormone (ADH), helps to concentrate the urine
during sleep, so that we produce less urine at night than during the day. A small percentage of bedwetters do not secrete enough ADH during sleep,
producing more urine than their bladders can hold. If they do not wake
up, the bladder releases the urine. If treated with an enuresis alarm,
these children learn to wake up to void the extra urine.
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In very few cases, enuresis may be caused by a physical problem such as a
urinary tract infection. This is rare in primary nocturnal enuretics,
however, and physical causes are more likely if there are daytime urinary
problems or in secondary enuretics.
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Psychological factors are seldom a cause of primary enuresis. If the
child has previously been dry, and then starts wetting again, one needs to
consider this possibility more seriously. However, if the child seems
happy and well-adjusted, and no particular stressors are evident, then an
appropriate physical examination by your GP to exclude a physical problem
should be adequate investigation.
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For information on the treatment options for bedwetting, click here. [ Next ]
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