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Most common causes of Nocturnal enuresis

Nocturnal Enuresis or Bedwetting

Bedwetting is one of the most common childhood complaints and it is actually the most frequent urological complaint among kids. It is medically referred to as nocturnal enuresis and it can be described as involuntary urination which takes place while the child is asleep. Nocturnal enuresis can only be diagnosed in children who are old enough to have a properly functioning bladder. This is mainly due to the fact that bedwetting usually occurs as a certain type of developmental delay. It is commonly associated with hereditary factors, so parents should not be so hard on their children.

Nocturnal enuresis can be easily classified into two different types and those are primary and secondary nocturnal enuresis. In normal conditions, bedwetting is prevented by a certain hormone called arginine vasopressin which is in charge of reducing urine production during the night and also by a person’s ability to wake up once the bladder gets full of urine. Once these two abilities get developed the child may achieve dryness and stop wetting the bed during the night.

The most common form of bedwetting is the one medically referred to as primary nocturnal enuresis. Once the child is old enough to stay dry, bedwetting is defined as a medical condition and it needs to include at least two wet nights each week in order to be defined as primary nocturnal enuresis. The starting age range when the child can be diagnosed with nocturnal enuresis is still the subject of many debates. Secondary nocturnal enuresis is a whole other thing by definition as it involves bedwetting which takes place after an extended period of dryness. This type of bedwetting is often triggered by certain types of medical conditions or emotional stress.

Causes of Bedwetting

In most cases of bedwetting, the underlying causes are associated with primary nocturnal enuresis and the two most common ones include neurological developmental delay and genetics. Delayed development may reduce the child’s ability to stay dry. Sometimes a child may suffer from a slowness of the nervous system which simply cannot process the feeling of a full bladder fast enough. Genetics also play an important role in bedwetting, so children of parents who suffered from nocturnal enuresis have a strong chance of suffering from the condition themselves. Unfortunately there are no tests which can prove that a child suffers from nocturnal enuresis simply because of developmental delays or genetic factors. This is why doctors usually take various other possible causes into consideration as well.

Excessive fluid consumption is known for leading to nocturnal enuresis. Children who suffer from attention deficit hyperactivity disorder are known for being very prone to nocturnal enuresis. Consumption of caffeine may also cause bedwetting in some cases. Chronic cases of constipation may also lead to enhanced pressure on the bladder and the onset of nocturnal enuresis. Numerous different types of infections and diseases may sometimes be held responsible for bedwetting in both children and adults. Insufficient production of the aforementioned anti-diuretic hormone sometimes triggers nocturnal bedwetting in children. Severe neurological and developmental issues can additionally be a big problem when it comes to staying dry during the night. Physical abnormalities such as an undersized bladder may sometimes be considered as a major cause of nocturnal enuresis.

There are various psychological issues such as extreme bullying, sexual abuse and death in the family which can also be held responsible for nocturnal enuresis. Upper airway obstruction may lead to sleep apnea which triggers nocturnal bedwetting in some cases. A peculiar fact is that there are certain cases of sleepwalking which have been associated with bedwetting.  Most of the time secondary nocturnal enuresis is associated with stress. There are also certain unconfirmed causes of bedwetting which include improper toilet training, food allergies and heavy sleeping.

Treatment and Management Options

The best thing one can do is to wait, because most children simply outgrow their problems with bedwetting. There are also various different types of bedwetting alarms available on the market, which produce a loud tone as soon as they detect any moisture. These alarms are wearable and they are very efficient in helping the child wake up when the sensation of a full bladder starts kicking in. There is another treatment option and that is desmopressin in the form of tablets. It actually replaces the anti-diuretic hormone and induces a reduced production of urine during the night. Certain types of prescription tricylic antidepressant drugs which have anti muscarinic properties have also been used in the treatment of nocturnal enuresis in some cases. Diapers and absorbent underwear are commonly used as condition management options.

Frequency of Bedwetting

There are 20 percent of children aged 5 who experience bedwetting, 10 to 15 percent of children aged 6 experience bedwetting, 7 percent of kids aged 7 experience bedwetting, 5 percent of kids aged 10 experience bedwetting, 1 to 2 percent of kids aged 15 cannot stay dry at night and the percentage of adults commonly affected by nocturnal enuresis is from 0.5 to 1 percent. 

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