Incontinence in children is a fairly common problem. It can be associated with both physiological disorders and psychological factors. Naturally, many parents are interested in questions about how the treatment of enuresis in a child looks like. After all, wet sheets and the inability to control your bladder negatively affect the condition of the baby.
Why do such disorders occur? Is night enuresis in a child of 6 years old dangerous? Does treatment include medication? When to start worrying about incontinence? What can doctors recommend? Answers to these questions are important for each parent.
What is a pathology?
Many parents are faced with a problem such as enuresis in children. Causes and treatment are, of course, important information. But first, it’s worth familiarizing yourself with the general information.
Enuresis is called involuntary urination, and this can happen both at night (during sleep) and in the daytime. In children up to a certain age, this condition is considered normal, since conditioned reflexes that help control urination are still at the formation stage. On the other hand, enuresis can indicate various diseases, emotional and psychological problems. By the way, according to statistics, boys face a similar pathology 2-3 times more often than their peers.
Naturally, a similar problem cannot but leave an imprint on the developing personality of the child. For example, nocturnal enuresis in children of 8 years old (we will consider the treatment in the article) can cause excessive shyness, nervousness, isolation. That is why the problem should not be ignored. So, what should the treatment for enuresis in a child look like? The answer to this question is important for every parent.
At what age can incontinence be considered a problem?
As you know, children need time to develop control over emptying the bladder. It is believed that nocturnal enuresis in a child of 5 years of age does not require treatment. Why? The fact is that up to 5-6 years, a conditioned reflex to urination occurs, therefore, by this time, periodic episodes of involuntary emptying can be considered the norm.
By the way, the treatment of enuresis in children of 8 years old can only be reduced to the correction of the daily regimen and consultation with a psychologist. At this age, isolated cases of nighttime urination can also be considered normal. Nevertheless, if such incidents occur constantly, occur even during wakefulness, this may indicate the presence of diseases and serious problems. In this case, it is very important to consult a doctor.
Classification
Before considering the treatment of enuresis in a child, it is worth familiarizing yourself with the forms of this pathology. Today, there are several classification systems. Depending on the causes, the time of occurrence and the development mechanism, two types of pathology are distinguished:
- Primary enuresis. A similar form of incontinence is indicated if the conditioned reflex to emptying the bladder has not yet been formed. A child could never fully control his urges.
- Secondary enuresis. In this case, we are talking about a problem that arose later, after the child learned to control urination, wake up at night and go to the toilet.
Incontinence can also be:
- isolated - in this case, there are only nightly episodes that occur during sleep;
- mixed - daytime episodes are added to bed incontinence, when the child behaves quite consciously, but urination still occurs involuntarily.
Depending on the characteristics of the clinical picture, there are:
- monosymptomatic enuresis - there is only incontinence, in everything else the baby behaves quite normally;
- polysymptomatic enuresis - there are other symptoms that indicate the presence of mental, neurological, endocrine and urological disorders.
Of course, such classification schemes are considered somewhat arbitrary, since much more factors need to be taken into account.
The main causes of incontinence
Many parents are faced with a problem such as night and day enuresis in children. Treatment in this case largely depends on the causes of the development of pathology, so it is worth exploring possible risk factors:
- A delay in the development of the central nervous system, which may be the result of brain injuries, pathologies suffered during childbirth or intrauterine development, and various infections that affect nerve tissue.
- Incorrect functioning of the urinary system is also often accompanied by incontinence. The list of causes includes such pathologies as vesicoureteral reflux (urine is thrown back from the bladder back into the ureter), bladder dysfunction, overactive bladder syndrome, etc.
- Risk factors include too much sleep. It is very difficult for a child to wake up, urination occurs during sleep, but the baby does not feel this.
- Incontinence may result from impaired secretion of the hormone vasopressin. It, in fact, regulates the processes of formation and excretion of urine. If the level of antidiuretic hormone decreases, then at night a large volume of urine is produced, which often leads to the development of enuresis.
- There is a genetic inheritance. According to statistics, if direct relatives (parents) have a similar problem, then the probability of developing urinary incontinence in a child is approximately 75%.
- Do not forget about the emotional state of the child. Long-term stress, mental trauma - all this creates the prerequisites for bedwetting.
In the process of diagnosis, it is very important to find out what exactly caused the emergence of such a problem as enuresis in a child. Treatment will largely depend on this.
What other symptoms are worth paying attention to?
You already know what enuresis is in children. Treatment in this case largely depends on the causes of incontinence and related complications.
Enuresis is said to be if the child cannot control the process of urination. In this case, incontinence episodes can occur several times a day or 1-2 times a month. Sometimes there are so-called imperative urges when the desire to empty the bladder is so strong that the child cannot control it.
Parents are advised to pay attention to other symptoms. Sometimes enuresis is associated with neurological and mental disorders. Symptoms such as increased anxiety and irritability, excessive shyness, isolation, vulnerability can join incontinence. Sometimes there are various phobias, as well as nervous tics, stuttering. The disturbing symptoms also include sleep disturbances, in particular, problems falling asleep, walking and talking in a dream, too deep or, on the contrary, superficial sleep, severe compression of the jaws, grinding of teeth. All these features must be reported to the doctor.
Diagnostic procedures
First, the doctor must collect the maximum amount of information. The history of the disease should include information on the nature of enuresis, the incidence of incontinence episodes, and the presence of concomitant symptoms. Also, the specialist will certainly ask if the child suffered any infectious diseases, whether there were any complications during childbirth or pregnancy, etc.
Next, a general examination is carried out, during which the state of the abdominal cavity organs is checked, the degree of sensitivity of the perineum, the tone of the anal sphincter, etc. are assessed.
The child also takes blood and urine tests. If there is a suspicion of injuries or anatomical abnormalities in the structure of the spinal cord, an X-ray is taken. If there are symptoms of disorders from the brain, then the baby is sent for electroencephalography. Additional diagnostic procedures include cystoscopy, uroflowmetry, ultrasonography of the kidneys and bladder.
Drug treatment of enuresis in children
What to do if there is a similar problem? How is enuresis in children eliminated? Causes and treatments in this case are closely related.
If there is a suspicion of a delay in the development of nervous regulation of urination, then certain medications can be used:
- Cortexin is often used. A similar tool accelerates the development of structures of the central nervous system. The drug is available in the form of a solution for intramuscular administration. The course of treatment, as a rule, consists of ten injections.
- Nootropic drugs are also used, in particular Calcium Hopantenate or Pantocalcin. Such drugs improve blood circulation in the brain, accelerate the transmission of nerve impulses, and help the child to consolidate new skills.
If the cause of enuresis is an increased activity of the bladder, which, incidentally, is accompanied by frequent urge to urinate, then the following drugs are included in the treatment regimen:
- “Oxybutynin” or “Driptan” - blocks the excessive activity of the muscle layer of the bladder. It is prescribed for treatment for children over five years of age. The course of therapy lasts about a month.
- Similar results are given by drugs such as Tolterodin and Detrusitol. These drugs are used more often, since they are better tolerated by the children's body.
If there is an infectious inflammation, then antibiotics of a wide spectrum of effects are used, in particular, Augmentin (children's form). "Kanefron" - a drug that contains plant components, helps to normalize the functioning of the excretory system and to cope with the effects of inflammation.
At times, drugs with antidiuretic properties are also included in the treatment regimen. This helps reduce the amount of urine produced at night. As for physiotherapy, sometimes doctors recommend paraffin baths designed to warm the suprapubic region.
The child is also referred for a consultation with a psychologist, especially if there is a suspicion of the psychological origin of enuresis. Classes with an experienced specialist help the baby cope with phobias, stress, irritability and other psychological, emotional problems.
Sometimes treatment may not be required at all. According to statistics, in about 15% of cases, the pathology disappears on its own, without any therapy. Doctors associate such self-healing with the completion of the formation of conditioned reflexes.
What is Minirin used for?
Treatment of enuresis (if the child is 7 years old or more) may include taking the drug “Minirin”. The active substance of this tool is desmopressin, which is an analogue of natural vasopressin. This hormone is secreted by the pituitary gland of the human brain.
Desmopressin acts on the distal sinuous tubules, increasing the permeability of the epithelium. This activates the processes of water reabsorption and leads to a decrease in the volume of urine excreted. Such a medicine is widely used to treat primary enuresis in children, as well as eliminate the symptoms of diabetes insipidus.
The drug is available in the form of small white tablets that need to be absorbed. The medicine has some contraindications. It cannot be used if the patient has the following problems:
- allergic sensitivity;
- various forms of renal failure;
- risk of heart failure;
- polydipsia;
- the medicine is also not prescribed for children under six years of age.
It is worth noting that such a tool is well tolerated by small patients. This is also indicated by the reviews of doctors. Adverse reactions, in particular nausea, weight gain, cramps, are extremely rare.
Do I need to wake a child at night?
We have already figured out how the treatment of enuresis in children at home looks like. In some cases, parents decide to wake the child up at night before the urinary bladder becomes empty. It is worth noting that a few years later, doctors recommended this approach.
Today, doctors do not recommend waking up a child. Suppose a child is 6 years old enuresis. Treatment through night rises is unlikely to have the desired effect. The fact is that for conscious urination it is necessary to fully wake the child, which is not always possible. If the baby is emptied in a state of drowsiness, then this only strengthens the unconscious mechanism of urination.
If you nevertheless decided to raise a child at night, then make sure that before going to the toilet the baby finally woke up. In this case, you must adhere to the scheme. During the first week, you need to wake the baby every hour. In the future, time must be gradually increased.
Parenting Tips
The treatment of enuresis in a child must be supplemented with the correct regimen and diet. In addition, for the baby is extremely important parental support. That is why you should adhere to some rules:
- Do not punish your child for episodes of incontinence. After all, this does not happen intentionally, but arbitrarily. Therefore, it is not recommended to scold the baby, make him wash wet sheets and focus too much on this. Such behavior of the parents will not give the desired result, but will only form complexes in the child. Promotion works much better. If the child woke up dry in the morning, then he must be praised.
- In no case should you reduce the daily amount of fluid you drink. Of course, if the child does not drink enough, episodes of incontinence will occur less frequently, but this can lead to dehydration, which is fraught with more complex consequences.
- However, a drinking regimen is necessary. Until 17:00, the child should drink 80% of the daily allowance, but in the evening, the amount of drink should be limited. Three hours before bedtime, you should not give your child too much watery fruits and products with diuretic properties. Also, in the evenings, it is not recommended for babies to drink tea and other drinks containing caffeine.
- Proper sleep is important. Therefore, try to lay the child at the same time.
- Before going to bed, the baby must be taken to the toilet.
- In the evening, active games, watching TV, playing at the computer are undesirable.
- It is important to create a calm atmosphere in the house - the child has nothing to listen to or be a participant in disputes, quarrels, conflicts, as this can only aggravate the situation.
- Try to create a comfortable place for your child to relax. If you cover the mattress with oilcloth, then on top there should be a dense but soft sheet that needs to be fixed so that it does not wrinkle and does not slip. The room should be ventilated before bedtime. It is important to maintain a comfortable temperature. If during sleep the child freezes, then the likelihood of involuntary urination increases. On the other hand, the heat in the room will make the baby thirsty.
- It is recommended to leave a muffled light source in the child’s bedroom - this will make the baby comfortable, the darkness will not frighten him, and the way to the toilet will not seem scary.
Enuresis in children: treatment with folk remedies
What else can parents do? How to cope with a problem such as enuresis in children? Treatment with folk remedies is possible. Herbalists in their arsenal have a lot of useful recipes:
- Good results are given by honey water. This is confirmed by numerous reviews. A teaspoon of honey (of course, natural) should be dissolved in 100 ml of warm boiled water. The child should drink this drink 30-60 minutes before bedtime. The medicine helps retain fluid in the body.
- Dill seeds also help to cope with the problem, as evidenced by the reviews of many parents. Preparing the medicine is simple: you need to pour a large spoonful of dry dill seeds with a glass of boiling water and insist. In the morning, the infusion obtained should be given to the child. Children under ten years of age consume half a glass a day. The dose for older children is 200 ml. If necessary, the medicine can be slightly sweetened.
Now you know what enuresis is in children. Treatment, reviews of certain techniques, the causes of the appearance of pathology - this is very important information that should not be ignored. The attending physician will be able to draw up the correct treatment regimen after a full diagnosis. Medical treatment, coupled with the correct regime of the day, the correct behavior of the parents, some psychological procedures and a relaxed atmosphere in the house will help to cope with the problem.