Nocturnal enuresis or night time urinary incontinence, commonly called bedwetting or sleep wetting. Nocturnal enuresis (bedwetting): involuntary wetting during sleep without any inherent suggestion of frequency of bedwetting or pathophysiology.
Children with nocturnal enuresis may have excessive nocturnal urine production, poor sleep arousal and/or reduced bladder capacity. Children with nocturnal enuresis may also have daytime urinary urgency, frequency or incontinence of urine.
CLASSIFICATION
Nocturnal Enuresis
Enuresis has been classified into persistent (primary) type and regressive (secondary type).
In primary enuresis, the child has never been dry at night. Primary nocturnal enuresis. This is the recurrent involuntary passage of urine during sleep by a child aged 5 years or older, who has never achieved consistent nighttime dryness
About 75 percent belong to this category and is probably the result of inadequate or inappropriate toilet training (e.g. excessively primitive parents).
The regressive type is often precipitated by stressful environmental events, such as a move to a new home, marital conflict in parent, birth of a sibling, or death of a family member.
TREATMENTS
he most important reason for treating enuresis is to minimize the embarrassment and anxiety of the child and the frustration experienced by the parents.
Preliminary management focusing on behavioral modification and positive reinforcement is often helpful.
Management depends on understanding of possible specific causative factors and appropriate measures to tackle any “stressors’’. Often, in addition, the following general instructions are helpful:
Reward the child for dry night.
Once bed wetting occurs, older children should be asked to wash their own clothes and soiled bed sheet.
Children should not be given any fluids after dinner.
Waking the child 1 to 2 hours after sleep to void urine again may help.
Punishment and humiliation by parents or siblings should be discouraged.
Behavioural techniques may also be used.
HOMOEOPATHIC TREATMENT
It should be focussed on the underlying cause. Bedwetting is a treatable condition in homeopathy. Homeopathy is a very effective natural treatment for enuresis. The homeopathic remedies for bedwetting are perfectly safe. These natural homeopathic remedies do not have any side effects at all.
ENCOPRESIS
The definition of encopresis requires the voluntary or involuntary passage of feces into inappropriate places at least once a month for 3 consecutive months once a chronologic or developmental age of 4 yr has been reached.
CLINICAL MANIFESTATIONS
Children with encopresis often present with reports of underwear soiling, and many parents initially presume that diarrhea, rather than constipation, is the cause. In retentive encopresis, associated complaints of difficulty with defecation, abdominal or rectal pain, impaired appetite with poor growth, and urinary (day and/ or night) incontinence are common. Children often have large bowel movements that obstruct the toilet.