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Mom: “Did you wet the bed again?”
Son: “Errrmm…. Thought I was in the toilet, only to wake up and find that I was still lying in bed.”
Soaked bed sheets on a drenched bed, a disappointed parent and an anxious child in wet pyjamas is a common setting associated with bed-wetting especially when the person involved is way past the age of being toilet trained.
Bedwetting, which is also referred to as nocturnal enuresis or commonly described as the involuntary voiding of urine while sleeping, frequently occurs at night. Often, parents or caregivers get worried when a child older than six years still wets the be four years. Some may gain bladder control earlier than the others due to individual variation. It is important to note that enuresis can occur during the daytime and can also affect adolescents and adults. In Nigeria, there are several myths about bed-wetting many of which tend to increase anxiety of the people involved. It is worthy of mention that in infants and very young children, micturition occurs spontaneously as a reflex, hence they do not think about where or when to urinate before they do. As age increases, bladder control is acquired.
Nocturnal enuresis can be classified as primary or secondary. Primary enuresis is considered when there has never been a period of bladder control (in terms of dryness), while secondary enuresis describes a case when bladder control has been achieved in the past (over six months). A usual practice among many parents/caregivers is blaming and shaming the child or person involved, while some go as far as punishing the individual or using derogatory names. This practice should be discouraged as it increases the level of anxiety in those affected.
There are certain factors that may increase the chances of an individual wetting the bed. Some of these include a positive family history, precocious or inadequate toilet training, medical conditions like urinary tract infections, diabetes, neurological disorders and sleep disorders. Enuresis has also been found to be commoner in males than females.
The major symptom of enuresis is wetting the bed. However, there may be other related symptoms, depending on the underlying cause. For instance, there may be burning sensation when passing urine, increased frequency of passing urine, passage of cloudy or blood-stained urine and constipation. More often, bed-wetting is the only symptom because enuresis usually occurs without any other co-existing conditions.
The extent of the condition (commonly the quality of life) as experienced by the individual, family or caregivers, determines when the decision to present at the hospital would be taken. It is observed to be common practice by some parents to prolong visiting the hospital with their wards over enuresis until a long time has passed. This practice should be discouraged as it is important for a thorough clinical evaluation be carried out so as to exclude co-existing medical conditions. The physician will guide through relevant investigations needed and recommend appropriate treatment. Generally, bed-wetting is considered as a social problem more than a medical one, thus the late presentation to the hospital (that is, when symptoms begin to affect the quality of life of the individual, their parents or caregivers.
Some remedies for bed-wetting include:
Maintain a bedtime routine of emptying the bladder before going to sleep.
Limit fluid intake in the evening or just before bedtime.
Assistance from parents/caregivers and family in waking the individual intermittently at night to void urine (does not apply to infants and very young children).
Limit the use of diapers at home to assist the child in attaining toilet training.
Use of bed-wetting alarms. This has shown significant improvement in people who bed-wet (for older children, adolescents and adults).
It helps a lot when the family gives reassurance, support and shows patience towards the person who bed-wets.
Reward every success, no matter how small.
Do not resort to punishment, no matter how long the symptoms persist.
Health quote of the week:
“The most certain way to succeed is always to try just one more time”
– Thomas Edison
