Bedwetting Health Article

Definition

Bedwetting, or enuresis, is a childhood condition of urinating in bed while asleep at night. It is a chronic condition that often resolves by itself before the teenage years.

Description

One of the major tasks of toddlerhood is to learn how to achieve conscious control over the timing of urination. Most children do not become fully toilet trained until they are about two to four years old. Before then, the parts of the nervous system in charge of bladder control are not fully developed and functional. In general, boys take longer to learn to control their bladders than girls, and daytime bladder control is easier for a child than overnight bladder control. There is a genetic aspect to bedwetting, so that parents who once had the condition often have children who wet the bed at night.

Causes & symptoms

Bedwetting is often due to the normal immaturity of the nervous system and the urinary system. For instance, up to age six, bedwetting is often due to nothing more than the bladder having a small capacity. In addition, the muscles that control the opening and closing of the urethra may not be sufficiently developed. Often it takes a while for a child learn recognition of bladder fullness, waking up, and going to the toilet. In most cases, urinary capacity and control increase over time, and the bedwetting problem will eventually be outgrown.

Surprisingly, a big cause of bedwetting is lack of sleep. If a child is not sleeping enough hours, then there will be less of the light, rapid eye movement (REM) sleep, and more periods of heavy, deep sleep. During the periods of deep sleep some children will have difficulty becoming aware of the urge to urinate and awakening to go to the toilet.

Bedwetting may be a sign of allergic reactions, which end up irritating sphincter muscles around the urethra. This contributes to a loss of bladder control during sleep. Heavy snoring, mouth breathing, and night sweats may all be indications of the presence of allergies.

Bedwetting can sometimes be due to emotional and psychological stress, including major life changes such as moving or a divorce. This usually leads to the type of bedwetting called secondary enuresis, in which a previous level of accomplishment with bladder control is lost. In other words, a child who has been dry at night will suddenly start wetting the bed again. This may indicate an underlying problem such as constipation, diabetes, physical defects in the urinary tract, sacral nerve disorders, a pelvic growth, urinary stasis, infection, kidney stones, or kidney damage. Secondary enuresis also frequently occurs in children who are being physically or sexually abused. A pediatrician should be consulted if the condition persists.

Only about 1% of bedwetting is caused by a serious underlying problem. If the following symptoms are present, a pediatrician or a pediatric urologist should be consulted:

• straining during urination
• a burning feeling or other discomfort during urination
• constant or recurrent dribbling of urine
• cloudy or pink urine
• bloodstains or other discharge on underpants or night-clothes
• an unpleasant urine odor
• onset of abdominal pain, backache, or fever
• constant thirst, especially at night
• sudden loss of bladder control previously mastered
• a child over the age of two who still shows no signs of being ready to learn bladder control