The Stress Of Bedwetting: Helping Kids Cope
For the 5 million U.S. children over age 6 who wet the bed, stress itself doesnt cause bedwetting, but bedwetting definitely causes stress. And that stress can be hard for kids to manage. There are bound to be activities a child feels theyre missing out on, they may be dealing with teasing by friends, or they may suffer from low self-esteem. Fortunately, theres a lot you can do to help your child physically and emotionally.
First, if your child was dry for awhile, try again the methods that got them dry before. If bedwetting alarms, behavioral changes, getting your child up at night to go to the bathroom, or a combination of these worked before, try them again. Experts at the American Academy of Family Physicians as well as urologists like Atala also offers these tips:
- Always be supportive of your child.
- Make sure they know that bedwetting isnt their fault.
- Dont blame or punish your child for wetting the bed.
- Let your child know bedwetting tends to run in families.
- Encourage your child to use the bathroom at night, then provide nightlights to make that easier.
- Urge your child to do the same things other kids do, like going to camp and sleepovers.
- Reward your child not for dry nights, but for following their bedwetting treatment plan.
- When bedwetting accidents occur, praise your child for trying to stay dry, and for helping to clean up.
Types Of Nocturnal Enuresis
Persistent Primary Nocturnal Enuresis is a condition which starts during childhood, where night time dryness has not been achieved for longer than six months. About 2 3% of adults over 18 years of age have this type of nocturnal enuresis. Adult Onset Secondary Enuresis is defined as nocturnal enuresis in which night time dryness has been achieved at some point in life. Dryness may have occurred for many years but then night time wetting suddenly begins at an older age.
Why Do Older Children And Teens Experience Bedwetting
Doctors arent exactly sure what causes enuresis, and every child is different. Your childs pediatrician can ask questions and run tests to rule out underlying medical conditions. Enuresis can be triggered by issues that are physical, mental or both.
Is your older child waking up to urine-soaked sheets and pajamas occasionally or every night? Finding the root cause is the first step to alleviating the problem and preserving your childs self-esteem. Here are ten common reasons why your child or teen could be wetting his bed at night.
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What Changes Can I Make To My Childs Behavior Or Routine To Help With Bedwetting
Your healthcare provider may suggest trying behavioral changes to begin. Behavioral techniques are changes you can make to your childs nighttime routine that dont involve medication. These techniques can include:
- Limiting fluids before bedtime: Dont give your child anything to drink at least two hours before bedtime. Make sure your child drinks plenty of fluids during the day.
- Going to the bathroom before bedtime: Make sure your child goes to the bathroom and empties his or her bladder completely before going to bed.
- Enuresis alarm: This is a device that makes a loud noise or vibrates to awaken the child when he or she starts to wet the bed. It has a wetness sensor that triggers the alarm so that the child can wake up and finish urinating in the bathroom. Over time, the child learns to wake up when he or she feels the sensation of a full bladder, and eventually might be able to sleep through the night without having to urinate. This technique may take several months to be successful.
- Bladder therapy: This approach is aimed at gradually increasing the bladders functional capacity by making the child wait to go to the bathroom. Increasing the length of time between bathroom visits helps enlarge the bladder to allow it to hold more urine.
- Counseling: Psychological counseling may be effective in cases where the child has had a traumatic event or is suffering from low self-esteem because of the bedwetting.
Surgical Treatment For Adult Bedwetting
The involvement of surgery when attempting to treat severe detrusor overactivity is limited and should only be considered when all other less invasive treatment options have proven to be unsuccessful. All of the procedures mentioned below have associated risks that must be considered and discussed with a healthcare professional.
Sacral Nerve Stimulation. Sacral nerve roots are stimulated by neuromodulation, a process where neurotransmitters control various neuron groups. This increases the external sphincter tone causing the detrusor muscle neurons to stop activity. When detrusor muscle neurons have a decreased activity level the muscle will not contract constantly, which ultimately causes less frequent urination episodes. SNS is recommended for people with moderate to severe urge incontinence and for whom other treatments have not been helpful or for whom prescriptions are contraindicated.
Clam Cystoplasty. This is a surgical treatment where the bladder is cut open and a patch of intestine is placed in between the two halves. The goal of this procedure is to reduce bladder instability and increase bladder capacity.
Detrusor Myectomy. This process is also known as autoaugmentation that involves removing a portion or all of the exterior muscle surrounding the bladder. It intends to strengthen bladder contractions while reducing the number of them.
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Hyperstimulation Can Adversely Affect The Nervous System Which Can Affect Nerve And Subsequent Muscle Control
The body’s voluntary and involuntary muscles are controlled by nerve impulses. The sphincter muscle, the muscle around the opening of the bladder which squeezes to prevent urine from leaking through the urethra, uses a combination of voluntary and involuntary actions.
The body manages both types of muscles normally when the body’s nervous system is not overly stressed. But both voluntary and involuntary muscles can behave erratically when the body becomes stress-response hyperstimulated. Examples of this erratic behavior include muscle twitching, involuntary tremors, weak muscles, muscles that shake when you move them, and bladder control problems, to name a few.
Also, some people wet themselves when they become overly excited, such as when afraid because of how the nervous system and involuntary muscle control is affected by stress.
The combination of the above three factors can contribute to nocturnal enuresis for some people. So again, while anxiety doesn’t directly cause nocturnal enuresis, it can be a contributing factor.
Addressing your bodys overly stressed state and the underlying factors associated with your overly apprehensive behavior could eliminate episodes of nocturnal enuresis.
If you are uncertain about your doctors diagnosis, however, you may want to seek a second and even third opinion. But if all three opinions agree, you can feel confident that anxiety/stress is the cause of this issue and not some other medical or biological problem.
The Pad And Bell Method
One way to help your child become aware of urinating during sleep is to use a pad and bell. With this simple system, a bell rings and wakes the child once the pad is wet. Over a period of a few weeks, the child gains greater bladder control until they are consistently waking up to go to the toilet. It is best to use this under the guidance and supervision of a doctor.
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When To See A Doctor
Bedwetting is normal for young children, who will usually grow out of it. Home treatments and training may be enough to prevent bedwetting.
People can talk to their doctor if they have any concerns about the well-being of a child, or if the child:
- did not wet the bed for 6 months but then started to again
- has additional symptoms that could indicate a UTI or underlying condition
- is wetting themselves in the daytime
- is emotionally affected by bedwetting
Adults should see a doctor about bedwetting, as this can indicate an underlying health condition.
The doctor will take a full medical history, assess the symptoms, and carry out a physical exam. They may also carry out urine tests and take X-rays to look at the health of the urinary tract and kidneys.
How Is Enuresis Treated
Doctors can do several things to treat bedwetting, depending on what’s causing it. If an illness is responsible, which is not very common, it will be treated.
If the history and physical exam do not find a medical problem and the urine tests are negative, several behavioral approaches can be used for treatment:
If you’re worried about enuresis, the best thing to do is talk to your doctor for ideas on how to cope with it. Your mom or dad can also give you tips on how to cope, especially if he or she had the problem as a teen.
The good news is that it’s likely that bedwetting will go away on its own.
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Which Types Of Doctors Treat Bedwetting
Routine evaluation and management of both primary and secondary enuresis should be in the domain of a pediatrician or family practice physician. If a complex cause for the child’s enuresis is determined or if routine therapies are not helpful, a consultation with a pediatric urologist would be in order.
How To Control Bedwetting
Until you can get bedwetting under control, take some simple steps to manage the situation: Put a waterproof cover or pad over your mattress or sheets to keep them dry. Wear absorbent underwear or pads to bed. Use special skin cleansing cloths and lotions to prevent your skin from getting irritated.
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Why Do I Have To Pee When I Wake Up In The Morning
Nocturia is a condition in which you wake up during the night because you have to urinate. Causes can include high fluid intake, sleep disorders and bladder obstruction. Treatment of nocturia includes certain activities, such as restricting fluids and medications that reduce symptoms of overactive bladder.
What Causes Bed Wetting In Girls
Bed wetting in girls can be caused by a number of factors. Among these factors are hormonal imbalances, an undersized bladder, genetics, deep sleep, stress and physical abnormalities, among others. Most doctors believe that bed wetting in girls is less common than bed wetting in boys.
Nighttime bed wetting, formally known as nocturnal enuresis, is a fairly common problem among children and tends to run in families. Normal bed wetting should cease after age 5. If it continues to be a problem past age 6, parents can turn to a doctor to check for any health problems in their child and to seek advice on treatment. The doctor might perform tests to check for a urinary tract infection and diabetes. Either of these health issues can lead to regular bed wetting in girls, and involuntary urination might end upon treatment.
Some girls experience nighttime bed wetting because of an improperly developed ureter, the tube through which urine moves from the kidney to the bladder. Another cause might be an underproduction of the hormone that reduces the amount of urine made by the kidneys. Spinal cord abnormalities can also lead to bed wetting in girls.
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What Medications Can I Give My Child To Help With Bedwetting
The following medications may be used alone or in combination with behavioral techniques to treat bedwetting:
- Desmopressin: This is the man-made version of the hormone vasopressin, which causes the kidneys to produce less urine. It is effective in about half of all cases, with better results in older children who have normal bladder capacity. The drug can lower sodium levels in children who take it, so you should limit the amount of fluids your child drinks after dinner.
- Oxybutinin: This medication is used to treat overactive bladder by reducing bladder contractions. It can be used along with desmopressin or the enuresis alarm method. It may be effective for children who wet the bed more than once each night and who also have daytime wetting.
- Imipramine: This drug is effective in 40% of cases, but it must be used with caution because of the risk of serious side effects.
Myth: Theres No Point Trying To Cure Bedwetting If A Child Is Depressed Or Anxious You Need To Treat The Psychological Symptoms First
Reality: Some kids who wet the bed are also distressed. But their psychological problems arent necessarily preventing them from getting dry, and successful treatment of their bed wetting symptoms may improve their psychological problems.
In a study of children suffering from both psychological problems and nocturnal enuresis, researchers successfully treated the bedwetting problem first . Not only did most kids become dry, they also showed less psychological distress after treatment for bedwetting.
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Why After I Pee Do I Leak
Stress incontinence: When you leak urine during activities, this is often stress incontinence. In this type of incontinence, your pelvic floor muscles are weak and no longer support your pelvic organs as they should. This muscle weakness means that you’re more likely to accidently leak urine when you move around.
Risk Factors For Bedwetting
Gender and genetics are among the main risk factors for developing bedwetting in childhood. Both boys and girls may experience episodes of nocturnal enuresis during early childhood, usually between ages 3 and 5. But boys are more likely to continue to wet the bed as they get older.
70 percent if both parents had bedwetting as children.
Bedwetting is also more common among children diagnosed with attention deficit hyperactivity disorder . Researchers dont yet fully understand the relationship between bedwetting and ADHD.
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What Happens If You Wet The Bed In A Hotel
There is no problem when it is just a few drops of urine on the bed sheet or mattress. However, it is a different matter if it involves a lot of pee. It can be difficult to deal with a urine-soaked mattress. If the problem also affects the box spring, then the housekeeping will surely have a hard time.
What Natural Remedies Can Treat Bedwetting At Home
Here are some tips for helping your child stop wetting the bed. These are techniques that are most often successful.
- Reduce evening fluid intake. The child should try to not take excessive fluids, chocolate, caffeine, carbonated drinks, or citrus after 3 p.m. Routine fluids with dinner are appropriate.
- The child should urinate in the toilet before bedtime.
- Set a goal for the child of getting up at night to use the toilet. Instead of focusing on making it through the night dry, help the child understand that it is more important to wake up every night to use the toilet.
- A system of sticker charts and rewards works for some children. The child gets a sticker on the chart for every night of remaining dry. Collecting a certain number of stickers earns a reward. For younger children, such a motivational approach has been shown to provide significant improvement in most children with a low relapse rate .
- Make sure the child has safe and easy access to the toilet. Clear the path from his or her bed to the toilet and install night-lights. Provide a portable toilet if necessary.
- Some believe that you should avoid using diapers or pull-ups at home because they can interfere with the motivation to wake up and use the toilet. Others argue that pull-ups help the child feel more independent and confident. Many parents limit their use to camping trips or sleepovers.
The parents’ attitude toward the bedwetting is all-important in motivating the child.
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Multiple sclerosis. Multiple sclerosis. In multiple sclerosis, the protective coating on nerve fibers is damaged and may eventually be destroyed. Depending on where the nerve damage occurs, MS can affect vision, sensation, coordination, movement, and bladder and bowel control. Multiple sclerosis is a potentially disabling disease
Why Is My 7 Year Old Son Wetting The Bed
While bed wetting is typical for boys up until 7 years of age, it can continue longer. The most common bed wetting causes are genetics, an underdeveloped bladder, deep sleep, and stress. Bed wetting in boys can also be caused by an infection and, in some cases, can be one of the first signs of childhood diabetes.
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What Are Risk Factors For Bedwetting
Risk factors for the development of enuresis include
- male gender and family history
- medical conditions such as abnormal anatomy or function of the kidneys, bladder, or neurologic system
There is no medical test that can pinpoint the cause of primary enuresis. Secondary enuresis more commonly reflects underlying pathology and thus warrants laboratory and possibly radiologic evaluation.
- A routine urine test usually is performed to rule out any urinary tract infection or kidney disease.
- An X-ray or ultrasound of the kidneys and bladder may be done if a physical problem is suspected. Occasionally, MRI examination of the lower spine/pelvis is indicated.
Generally, medical professionals divide bedwetting into uncomplicated and complicated cases.
Children who have complicated bedwetting may be referred to a specialist in urinary tract problems for further evaluation.
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