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 baby's condition in the first place.
Why do these disorders occur? Is nocturnal enuresis dangerous in a 6-year-old child? Does the treatment involve medication? When should you start worrying about incontinence? What can doctors recommend? The answers to these questions are important for every parent.
What is pathology?
Many parents are faced with such a problem as enuresis in children. Causes and treatment is, of course, important information. But first, you should read the general information.
Enuresis is called involuntary urination, and this can occur both at night (during sleep) and during the day. In children up toa certain age, such a condition is considered normal, since the conditioned reflexes that help control the processes of urination are still at the stage of formation. On the other hand, enuresis can indicate various diseases, emotional and psychological problems. By the way, according to statistics, boys are faced with a similar pathology 2-3 times more often than their peers.
Naturally, such a problem cannot but leave an imprint on the developing personality of the child. For example, nocturnal enuresis in children aged 8 years (we will consider its treatment in the article) can cause excessive shyness, nervousness, isolation. That is why the problem should not be ignored. So, what should the treatment of 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 the emptying of the bladder. It is believed that nocturnal enuresis in a 5-year-old child does not require treatment. Why? The fact is that until the age of 5–6 years, the formation of a conditioned reflex to urination occurs, so by this time, periodic episodes of involuntary emptying can be considered the norm.
By the way, the treatment of enuresis in children 8 years old can be reduced only to the correction of the daily routine and consultation with a psychologist. At this age, isolated cases of urination at night can also be considered the norm. However, if such incidents occur constantly, even during the waking period, then this may indicate the presencediseases and serious problems. In this case, it is very important to see 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 mechanism of development, two types of pathology are distinguished:
- Primary enuresis. A similar form of incontinence is said if the conditioned reflex to empty the bladder has not been formed. The child was never fully in control of 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.
Also incontinence can be:
- isolated - in this case, there are only nocturnal episodes that occur during sleep;
- mixed - daytime episodes join nighttime incontinence, when the child behaves quite consciously, but urination still occurs involuntarily.
Depending on the characteristics of the clinical picture, they are distinguished:
- monosymptomatic enuresis - only incontinence occurs, otherwise 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 schemesare considered somewhat conditional, since many more factors need to be taken into account.
Main causes of incontinence
Many parents are faced with such a problem as nocturnal and daytime 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:
- Delay in the development of the central nervous system, which may be the result of brain injuries, pathologies suffered during childbirth or intrauterine development, various infections that affect the nervous tissue.
- Improper functioning of the urinary system is also often accompanied by incontinence. The list of causes includes pathologies such as vesicoureteral reflux (urine is thrown from the bladder back into the ureter), bladder dysfunction, overactive bladder syndrome, etc.
- Risk factors include too much sleep. It is very difficult for the child to wake up, urination occurs during sleep, but the baby does not feel it.
- Incontinence may be the result of 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 a large volume of urine is produced at night, 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%.
- Don't forget aboutemotional state of the child. Prolonged stress, mental trauma - all this creates the preconditions for bedwetting.
In the process of diagnosis, it is very important to find out what exactly caused the appearance of such a problem as enuresis in a child. Treatment will largely depend on this.
What other symptoms should I look out for?
You already know what enuresis is in children. Treatment in this case largely depends on the causes of incontinence and associated complications.
Enuresis is said to be when a child cannot control the process of urination. In this case, episodes of incontinence 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. Incontinence can be accompanied by symptoms such as increased anxiety and irritability, excessive shyness, isolation, vulnerability. Sometimes there are various phobias, as well as nervous tics, stuttering. Alarming symptoms also include sleep disturbances, in particular, problems with falling asleep, walking and talking in a dream, too deep or, conversely, superficial sleep, strong clenching of the jaws, grinding of teeth. All these features must be reported to the doctor.
Diagnosticprocedures
To begin with, the doctor must collect the maximum amount of information. The history of the disease should include information about the nature of enuresis, the frequency of episodes of incontinence, the presence of concomitant symptoms. Also, the specialist will definitely ask if the child has had any infectious disease, if there were any complications during childbirth or pregnancy, etc.
Followed by a general examination, during which the condition of the abdominal organs is checked, the degree of sensitivity of the perineum, the tone of the anal sphincter, etc.
The child also has blood and urine tests. If you suspect the presence of injuries or anatomical abnormalities in the structure of the spinal cord, an x-ray is performed. If there are symptoms of brain disorders, then the baby is sent for electroencephalography. The list of additional diagnostic procedures includes 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 treated in children? Causes and treatments in this case are closely related.
If there is a suspicion of a delay in the development of the nervous regulation of urination, then certain drugs can be used:
- Cortexin is often used. Such a tool accelerates the development of the structures of the central nervous system. The drug is produced in the form of a solution for intramuscular injection. The course of treatment usually consists often injections.
- Nootropic drugs are also used, in particular Calcium Hopantenate or Pantocalcin. Such funds improve blood circulation in the brain, accelerate the transmission of nerve impulses, and help the child consolidate new skills.
If the cause of enuresis is increased activity of the bladder, which, by the way, is accompanied by frequent urge to urinate, then the following medications are included in the treatment regimen:
- "Oxybutynin" or "Driptan" - blocks excessive activity of the muscular layer of the bladder. It is prescribed for the treatment of children older than five years. The course of therapy lasts about a month.
- Similar results are given by drugs such as Tolterodine and Detruzitol. These drugs are used more often as they are better tolerated by the child's body.
If there is an infectious inflammation, then broad-spectrum antibiotics are used, in particular Augmentin (children's form). "Kanefron" - a drug that contains herbal ingredients, helps to normalize the excretory system and cope with the effects of inflammation.
Sometimes medications with antidiuretic properties are also included in the treatment regimen. This helps reduce the amount of urine produced at night. When it comes to physical therapy, sometimes doctors recommend paraffin packs designed to warm the suprapubic area.
The child is also referred for a consultation with a psychologist, especially if there is a suspicion of a psychological origin of enuresis. Lessons with an experienced specialisthelp the baby cope with phobias, stress, irritability and other psychological, emotional problems.
Sometimes no treatment is needed 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 older) may include taking Minirin. The active substance of this remedy is desmopressin, which is an analogue of natural vasopressin. This hormone is secreted by the pituitary gland in the human brain.
Desmopressin acts on the distal convoluted 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. A similar medicine is widely used to treat primary enuresis in children, as well as to eliminate the symptoms of diabetes insipidus.
The drug comes in the form of small white tablets that need to be sucked. The medicine has some contraindications. It should not be used if the patient has the following problems:
- allergic sensitivity;
- various forms of kidney failure;
- risk of heart failure;
- polydipsia;
- drug is also not given to children under the age of six.
It is worth noting that such a remedy is well tolerated by smallpatients. The opinions of doctors also speak about this. Adverse reactions, in particular nausea, weight gain, convulsions, are extremely rare.
Should I wake my baby up at night?
We have already figured out what the treatment of enuresis in children looks like at home. In some cases, parents decide to wake the child at night before the involuntary emptying of the bladder occurs. It is worth noting that a few years later, doctors recommended this approach.
Today, doctors do not advise waking the child. Suppose there is enuresis in a child of 6 years. Treatment through night rises is unlikely to have the desired effect. The fact is that for conscious urination it is required to completely wake up the child, which is not always possible. If the baby empties while half asleep, then this only reinforces the unconscious mechanism of urination.
If you still decide to raise the child at night, then make sure that the baby is completely awake before going to the toilet. In this case, you must adhere to the scheme. During the first week, you need to wake the child every hour. In the future, the time should be gradually increased.
Helpful tips for parents
Treatment of enuresis in a child must be complemented by the correct regimen and diet. In addition, the support of parents is extremely important for the baby. That is why it is worth following some rules:
- Don't punish your child for episodes of incontinence. After all, this is not intentional, butarbitrarily. Therefore, it is not recommended to scold the baby, force him to wash wet sheets and focus too much on this. Such behavior of parents will not give the desired result, but will only form complexes in the child. Rewards work much better. If in the morning the child woke up dry, 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, then episodes of incontinence will occur less often, but this can lead to dehydration, which is fraught with more difficult consequences.
- Nevertheless, the drinking regimen is necessary. Until 17:00, the child should drink 80% of the daily norm, but in the evening, the amount of drinking should be limited. Avoid giving your child too many watery fruits and diuretic foods three hours before bedtime. Also, in the evenings, it is not recommended for babies to drink tea and other drinks containing caffeine.
- Correct sleep is important. So try to put your baby to bed at the same time.
- Before going to bed, the baby must be taken to the toilet.
- In the evening hours, active games, watching TV, playing at the computer are undesirable.
- It is important to create a calm atmosphere in the house - the child does not need to listen to anything or be a participant in disputes, quarrels, conflicts, as this can only aggravate the situation.
- Try to create a comfortable place for the child to rest. If you cover the mattress with oilcloth, then there should be a dense but soft sheet on top, which must be fixed so thatshe did not wrinkle or slip. The room must be ventilated before going to bed. It is important to maintain a comfortable temperature. If during sleep the child is cold, 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 subdued light source in the child's bedroom - so the baby will be comfortable, the darkness will not scare 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 such a problem as enuresis in children? Treatment with folk remedies is possible. Herbalists have a lot of useful recipes in their arsenal:
- Honey water gives good results. This is confirmed by numerous reviews. A teaspoon of honey (of course, natural) must 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 resulting infusion 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 methods,the causes of the appearance of pathology are very important information that should not be ignored. The attending physician will be able to draw up the correct treatment regimen after a complete diagnosis. Drug treatment, coupled with the right daily routine, the right behavior of parents, some psychological procedures and a calm atmosphere in the house will help to cope with the problem.
