Enuresis (bedwetting) is an involuntary passage of urine caused by variety of factors. It can occur either during the day or at night (though some restrict the term to bedwetting that occurs at night). It is commonly known as bed-wetting. Nocturnal enuresis, or bed-wetting at night, is the most common type. Daytime wetting is called diurnal enuresis. Mixed enuresis is a combination of nocturnal and diurnal type, wherein urine is passed during both waking and sleeping hours. Bedwetting is common before the age of 7 years and is not a major concern as, before the age of 7, the child does not have control over the bladder. But, if bedwetting continues after the age of 7, it is considered a problem.
Types of Bed wetting
1)Primary Enuresis: Bed wetting is since childhood
2)Secondary Enuresis: Bed wetting in children who have been trained to be continually dry for about minimum six months, but revert to wetting again
Primary enuresis is mainly because of delay in maturation of the nervous system. At the age of five years normally children develop good control over bladder. Approximately 16-17% of children wet the bed once a month and male are twice likely as compared to females.
Primary enuresis is inability to recognize message send by nervous system that the bladder is full to the sleep arousal center of the brain while asleep. It is observed that bladder capacity is often smaller in children having primary enuresis and they don’t awake when their bladder becomes full. The child cannot hold urine for entire night. There may be an emotional cause due to continuous conflict between parents which is not supported medically. Child that is suffering from sleep disorders or sleep apnea is at risk. Some children with symptomaticadenotonsillar hypertrophy may get some relief if tonsils and adenoids removed surgically operation called as Adenotonsillectomy.
Secondary enuresis develops after being continually dry for about minimum six months. It may arise due to some other existing medical conditions listed below.
1)Urinary tract infection which causes bladder irritation and leading to urgency or increased frequency
2)Type 1 Diabetes with increase blood sugar levels causing frequent urination
4)Diseases, injury or abnormalities related to nervous system
5)External pressure on bladder for example rectal stool mass
- Fluid intake at night
- Small bladder
- The bladder is irritated by the bowels
- Inability to know if the bladder is filled
- Urinary tract infection
- Stress and anxiety
- Hyperactivity in children
- Lack of attention
- Complete case history, repeated voiding of urine into bed or clothes with presence of clinically significant distress or impairment in social, academic activities
- Physical examination
- Laboratory investigations -urine culture, urinalysis to rule out urinary tract infection or kidney disease
- X-ray/Ultrasound of kidney and bladder (KUB) if physical problem is suspected
Homeopathy treats a person as a whole. Here, we need awareness about the physical, mental, and emotional aspects. Also, the medical history, sleep habits, dreams, digestion, appetite, the personality of the child, and circumstance of the child will give clue to select the homeopathic remedy which will cure the child.
This remedy is indicated for children who have frequent and profuse urination after midnight approaching the morning hours. A good remedy choice if the bedwetting is due to a bladder infection.
Indicated when the child urinates while dreaming of urination.
Indicated when the individual wets the bed during nightmares and dreams, experiences incontinence such as passing water without any cause, with involuntary stools, without feeling any relief. It can be used on the child that has the constant urge to urinate.
Indicated for the child that loves sweets and spices and who wets the bed in the early half of the night (before midnight). It can also be used on the child that sleeps with his/her feet sticking out of the covers and experiences vivid dreams.
When the child urinates frequently at night due to fear.
When there is a constant dribbling of urine due to a weak bladder. The child may wake up with only a small amount of urine on his/her clothing.
When the bedwetting is significantly more during the winter compared to summer.
This remedy can be used to treat bedwetting and kidney problems. It is often recommended in female children, if they wet the bed during the first half of the night and love to be active and dance.
It is a medicine used to treat bedwetting related to worms. Grinding of teeth during sleep, shrieking, crying or being scared during sleep, an irritable or obstinate behavior, rubbing of nostrils are some other symptoms that indicate the need for this medicine.
It is used to treat bedwetting in cases where the urine has a foul, offensive smell. The urine also tends to leave brown stains on the bed sheet.