Already in 3-4 years, children do not need diapers - they independently go to the potty, can control the processes of urination and bowel movement. But these are general statistics. With specific kids, things can be completely different. Someone periodically wakes up in a wet bed, someone cannot endure the pot, someone at an older age needs diapers. Moreover, such problems can be either isolated or constantly haunting the child. It makes sense to talk about enuresis.
What is enuresis in children? This is a fairly serious disease that requires appropriate treatment. In the article we will also analyze its features, varieties and causes.
Forms of the disease
What is enuresis in children? This is urinary incontinence caused by problems with both the urogenital and the nervous system. There are several forms of the disease:
- Primary and secondary.
- Night and day.
- Neurotic and neurosis-like enuresis.
We will analyze these categories in more detail.
Primary and secondary form
We continue to consider what enuresis is in children. The primary type of disease is given to those children who have not had "dry nights" since birth. Who have not formed a control of urination. A child cannot control this process, day or night.
On average, the formation of such control begins in children in 1-3 years. And ends at 4 years old. By this time, a conditioned-reflex connection has already been fully formed: urge to urinate forces the child to perform certain actions - to go to the toilet, to the potty. And in the case of primary enuresis, there is a delay in the formation of this important connection.
With secondary enuresis, the situation is somewhat different. The baby has already formed the connection "urge to urinate - go to the potty." But for some reason it was destroyed. What could cause a reflex disorder? Causes of enuresis in children (night and day) can be both certain psychological factors and somatic chronic diseases. For example, diabetes, urinary tract infections.
The child still can not tell what is happening with his body. Or hesitate to do it. Then the body begins to "speak" for him. Since at a young age there is still a close relationship between somatic and emotional processes.
Night and day form
Daytime enuresis in children is not very common. More common is the nocturnal form of the disease. That is, it implies the presence in a child older than five years of the fact of involuntary urination in a dream.
Often this is affected by improper water regime. Normally, the number of urinations per day is 7-9, depending on the age and volume of the liquid drunk. During a night's sleep, a healthy body has a break in urination. In a child suffering from nocturnal enuresis, this does not happen.
According to statistics, 10-15% of children aged 5-12 years suffer from this form of the disease. As you grow older, this percentage, of course, decreases. But according to the same statistics, in 1% of patients enuresis persists in adulthood. Moreover, in boys, the disease occurs 1.5-2 times more often than in girls.
Neurotic and neurosis-like form
Speaking about what is enuresis in children, it should be noted that it is customary to distinguish a neurotic and neurosis-like form of the disease. As for the latter, its most common reason is the organic damage to the child’s nervous system. It could happen during its intrauterine development or as a result of a neuroinfection.
The result here is one - the delayed formation of control over the processes of urination. Or the complete destruction of this function, successfully formed earlier. This form of enuresis does not depend on the emotional, psychological upheaval that the child may have experienced. However, it can intensify with hypothermia, overwork, excessive physical activity. Conspiracies from enuresis in children here, of course, will not help - this is only self-hypnosis. I need the help of a qualified doctor.
But with the neurotic form of the disease, the function of controlling urination is violated under the influence of precisely various psychological causes. This is a kind of response of the body to various stressful situations. Moreover, psychological trauma affects the child not only in reality, but also in a dream. She will be repeated in his drawings, dreams, games, conversations. If you believe the reviews, the treatment of enuresis in children in this case is based on psychological assistance. As soon as it is possible to cope with the consequences of psychological trauma, enuresis will no longer bother the child.
Reasons for the condition
In the article, we analyze the causes and treatment of enuresis in children. As for the first, it’s hard to identify unequivocal reasons here.
Doctors begin the diagnosis by asking how the mother went through pregnancy and childbirth. Since the following causes of enuresis lie here:
- Intrauterine hypoxia of the fetus.
- Delayed intrauterine development of the child’s nervous system.
- Postponed neuroinfection.
- Various birth injuries.
Doctors are also interested in a hereditary predisposition to the disease. And for good reason. Indeed, according to statistics, if one parent suffered from enuresis in childhood, then the probability that the problem will appear in the child is 45%. And if both parents, then the indicator rises to 75%.
As for young children, for them enuresis is a consequence of the fact that the child was not promptly vaccinated with self-care skills, the concept of hygiene. He needs to be taught in a timely manner (but not too early) to use a pot. It was the parents at first who should monitor the complete and timely emptying of his bladder, remind the child that he needs to go to the toilet.
Parents need to try to wean their children from walking in diapers after two years. If the baby does not feel discomfort after urinating in his pants, this will not teach him that it is important to go to the pot on time. But in no case should you leave the child in wet clothes as a punishment.
As for older preschoolers and primary schoolchildren, they have the main cause of enuresis - improper drinking regimen. For example, in a school, section or circle, the child does not have time to drink properly. But in the evening at home he makes up for lost time. On the basis of a crowded bladder, a nocturnal form of the disease occurs.
Now about the treatment of enuresis in children. Reviews of therapy are ambiguous: some parents note the success of the use of medications prescribed by the doctor. Someone is talking about the benefits of physiotherapy and homeopathy. There are parents who again turned to the diapers in anticipation that the problem would resolve itself - tried and tested treatment methods were ineffective. Of course, in the reviews there is more than one case where, as a child grew older, enuresis passed without drug therapy.
But many needed psychological help. In the same reviews we will see that the emotional situation in the family plays a significant role. Such an unpredictable reaction may arise in response to the constant scandals of parents, their addiction to thrillers and horror films, physical punishment of a child, the birth of a younger brother or sister, frequent moving and other traumatic, unstable situations. A child psychologist will be able to work out the situation that traumatizes the child and help her survive. But often enuresis acts as a “side effect” of stress, depression, and fear.
What does the child feel?
What is enuresis in children? It is also a psychological trauma for the child himself. Caused not only by his problem, but also by the attitude of parents, peers and others to her:
- A child may experience a difficult internal conflict: he feels guilty, worries about what is happening, but at the same time feels that he cannot cope with it on his own. He does not understand how to stop this.
- A big blow is inflicted on the child’s self-esteem, his self-confidence, if his parents punish him because of enuresis, peers mock him, people around him negatively, even if they do not directly express their opinion.
- The child suffers from some of its limitations due to illness: it is difficult for him to stay out of the house for a long time, it is inconvenient to spend the night at a party. He is constantly afraid that new acquaintances will find out about his problem and take it negatively.
When is a doctor necessary?
Many parents mistakenly consider enuresis to be a temporary childhood problem. Moreover, they punish or abuse the child for this. Yes, enuresis can go away with age by itself, but a deep mental trauma will not go anywhere. It can develop into a neurosis or a more serious mental illness.
As soon as the parents noticed the fact of a repeated lack of control over urination in the child, the problem should be addressed to specialists: pediatrician, nephrologist, neurologist, urologist, endocrinologist, neuropathologist, pediatric psychologist. In fact, doctors prescribe additional tests and examinations.
Be sure to consult a doctor in the following cases:
- If for a long time after a complete weaning from diapers, the child again began to urinate in bed.
- If day and night, he can hardly control the urge to urinate.
- If the child continues to urinate both in bed and in panties after he is 5 years old.
In addition, pay attention to additional disturbing symptoms that require an immediate visit to the doctor:
- The child feels the urge to urinate more often than usual.
- When urinating, complains of a burning sensation.
- The child suffers from severe unreasonable thirst.
- The baby has swelling on the feet and ankles.
- Enuresis returned to the child after a long break.
Diagnostics
The diagnosis is determined by a specialist on the basis of a visual examination of the patient, his medical history, complaints of symptoms of both the child and his parents. The doctor will ask the following questions:
- Does the child have problems with urine retention throughout the day?
- Are there periods of time when he does not suffer from enuresis?
- What is the family history of this disease - have parents, close relatives suffered from it?
- How often does a child suffer from enuresis?
- Does he snore at night?
- How does this problem affect the child, his communication with his family, peers, others?
- What treatment methods were used independently?
To clarify the diagnosis, the doctor may order the delivery of urine for analysis, suggest keeping a 24-hour urination diary, where parents must write down the amount of fluid the child drinks and the urine excreted by his body.
Drug therapy
Are enuresis pills available for children? Yes, but such funds cannot be prescribed on their own. They should be prescribed by the attending physician if necessary.
In particular, it is prescribed for children with enuresis "Minirin". This is a hormonal drug. It contains synthetic hormones - the very ones that are lacking in patients with enuresis. Accordingly, it will be effective only in those children whose lack of control over urination is caused by problems with the nervous system. If the cause of enuresis is, for example, urology, Minirin will be powerless.
As for "Driptan" in children with enuresis, reviews about the drug are also mixed. Not all patients helped the drug. Some of the parents note its complete uselessness, some - temporary assistance. We can say that its effectiveness is individual. Such enuresis pills in children have side effects - in particular, skin rashes. Assigned only in case of serious problems with enuresis. Indications for use are urinary incontinence caused by both neurogenic disorders and motor incontinence. In particular, the medicine is prescribed for childhood enuresis.
Among the alternative remedies, one can distinguish Atarax, Pantokaltsin. But then again, the benefits of treatment are individual. The drugs are not equally effective for all patients.
Among drug-free methods, enuresis alarm clock collects many reviews. There are many patients to whom this method helped to cope with enuresis. But there are those who noted its futility in their case. Authors of reviews and the high cost of such treatment are distinguished.
Home treatment
We analyze the causes and treatment of enuresis in children. As for the latter, psychotherapy also plays a significant role. Moreover, not only in the office of a specialist, but also at home. Often there are symptoms of enuresis in children in response to the emotional state of the parents. As soon as the situation at home is normalized, the disease recedes.
Experts advise parents the following:
- In no case do not scold, punish or humiliate the child for this problem. Such behavior will only aggravate the situation, cause the baby a sense of guilt, spoil his self-esteem. And perhaps leave a trauma for life.
- If enuresis occurred abruptly, the most likely cause was a traumatic situation. Gently talk to your child about what's bothering him. Eliminate the cause. With her, the disease can go away.
- When talking with a child about enuresis, always be gentle and considerate. Be sincere, attentive to the problems of the baby. He must be sure that you accept him as he is, do not condemn him and always protect him.
- Never discuss with a child his delicate problem with strangers. This can forever deprive you of his trust, aggravate the baby's guilt for the disease.
- Nurture responsibility for your condition in your child. Give him the idea that treatment will surely help him.
- Make a daily routine, a drinking regimen for your child and try not to back down from him.
- Limit, as far as possible, the child from irritating, stimulating effects during the day and especially before bedtime. Here he should not experience strong emotions and unrest.
- In the evening hours, reduce the amount of fluid drunk by the child. Limit the consumption of vegetables, fruits, and other “aquatic” or diuretic products at this time.
- Make sure that the child must empty the bladder before going to bed.
- Beds in children suffering from enuresis should be tight. If the child sleeps soundly, then it is better for adults to turn it over several times lightly at night.
- Wet clothes, wet linen should be replaced immediately. Well, if the child will actively participate in this process (of course, voluntarily).
- Protect the child from hypothermia, long walks and situations when, in response to the urge to urinate, you cannot immediately go to the toilet.
- Give your child as much time as possible: take longer walks with him in the fresh air, read together, engage in creativity, play educational games. After all, when the child's hands are involved, this helps to get rid of emotional overstrain.
Enuresis is a more serious disease in terms of psychology. If the control over the urge of the bladder in most children with age still appears independently, then psychological trauma from improper treatment or its absence can remain for life.