Enuresis or bed wetting of children

A few youngsters void the bladder automatically and wet the bed at an age past which the sphincter control is typically evolved.

There are two types of enuresis

1. Primary
2. Secondary

Primary enuresis

There is delay in the maturation of neurological control of sphincters and such children have usually never been dry at night. There is often an organic basis for this, such as mental sub-normality.

Secondary enuresis

The sphincter control is developed at the normal age and the child remains dry for several months after which the child again stats wetting his bed at night.

Etiology / causation

1. Excessively enthusiastic attempts at toilet training by the parents, emotional disturbances in the child or child-parent mala-adjustment
2. Sub-conscious desire of the child to gain care and attention of his parents as in earlier childhood
3. It may be a manifestation of subconscious resentment against the parents. Thus enuresis often has a psychological basis
4. Children with nocturnal enuresis usually sleep very deeply at night and it may be difficult to arouse them. Signals from distended bladder to empty it do not reach the conscious level of there mind during sleep and lead to involuntary emptying of the bladder
5. Somebody believe, due to worm. Worm only bring itching nothing else. There is no relation to worm and enuresis

Management

1. Organic causes like juvenile diabetes mellitus, anomalies of urinal tract, nephropathies and neurological illnesses should be excluded aby physical examination and investigation
2. As the condition is harmless and self limiting, the child and parents should be reassured
3. Attempt should be made to minimize the emotional impact of enuresis on the child
4. The parents are advised not to nag, criticize or reprimand the child for wetting the bed at night. The bed sheet should be quietly changed next morning without making the child conscious of it
5. The child should refrain from taking beverages, such as tea, milk of sherbet after 4 o 5 O'clock in the evening. He should be habitually made to pass urine before retiring o bed. Guardians ought to excite him completely again following a few hours of rest and convince him to walk independent to the latrine to exhaust his bladder
6. The bladder ought to be prepared to hold pee for longer time. This may be done by making the child drink large quantity of water during day and persuade him to delay emptying of the bladder as long as feasible

Treatment

There are some homeopathic medicine can control it along with management

Belladonna 6, Equisitum 6 , silicea 6X

Belladonna: The dose is one drop twice daily for first 7 days, then 7 days rest, again for 7 days

Equisitum 6: This medicine is also in same manner as Belladonna

Silicea 6X: Two tablets twice daily and rest of dose same as Belladonna