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Enuresis nocturna – Causes and Treatment

Enuresis nocturna – Causes and Treatment

 

Enuresis nocturna is usually met before the puberty. Boys suffer from it more than girls. Enuresis is one of the most common children’s neuroses.  Regular wetting after the age of 3 is considered as pathological.  According to some authors the limit is 4 years. The following types of enuresis are distinguished:

Night - enuresis nocturna
Day - enuresis diurna

Enuresis nocturna could be combined with diurnal enuresis, during the afternoon sleep.
When young children are getting wet during play and laughter is not defined as diurnal enuresis!
Primary - enuresis persistens (continuing) – where physiological enuresis continues after the age of 3 (4) years.
Secondary - enuresis aquisita (acquired) – if the child has stopped wetting and after a prolonged period (years) starts wetting again.
There are also temporary and permanent enuresis.

Enuresis nocturna

Enuresis nocturna

 

Reasons to Enuresis nocturna

Immaturity of the brain center for urination
The official medicine explains enuresis nocturna with the slow maturation of the “guard” post in the cortex which provides the control over the bladder.   This theory could explain the primary form of enuresis.
Cold - This is the main reason for the temporary enuresis. Children usually catch a cold when they walk barefoot or sit on a cold and damp floor without insulation. This type of enuresis is could also occur in acute respiratory diseases.
Neurosis - Enuresis is more commonly met in nervous children and children living in unhygienic conditions. Fright is one of the basic causes for enuresis, even if parents do not know about it. Enuresis is commonly met in the beginning of first grade!

Warning! - Diagnosis of enuresis nocturna as a manifestation of neurosis is defined after eliminating kidney and urinary tract infections, diabetes mellitus and insipidus, epilepsy, polyps in the nose, enlarged tonsils, intestinal worms, anemia (from irregular diet and malnutrition) and others.

Treatment of enuresis nocturna

General principles
• If possible, treatment should be in accordance with the cause.
• Do not wait for puberty! Then the disease could disappear or increase.
• It will be good if the child (during treatment) is exempted from physical education classes and sports.
• During the colder months of the year the child should sleep with warm socks.
• When there is sun, wind, rain and snow, or when going out, the child always needs to wear a hat.
• If parents are nervous, the child will communicate with them less and should be taken care of someone who is calm!
• Threats and punishments during the treatment are absolutely contra-indicated because it leads to deeper problem!

Diet
The main thing is limiting liquids after 6 p.m. In such a way children do not wake up at night to urinate. Fatty meats and canned fish should also be limited. Boiled eggs with toasts are recommended, or oatmeal, sweetened with honey and lemon for breakfast. It is good if herbal teas include field horse-tail, blackberry leaves, cranberry leaves, St. John’s wort. At lunch meals with lamb, beef, chicken or fresh fish are recommended.   Dinner should be vegetarian. Also at night liquid foods have to be avoided because they cause frequent urination. A teaspoon of honey is given before the night sleep, in which ten grained mustard seeds are mixed, finely crushed.  A bag with few chestnuts is good to be placed under the child’s pillow.

Psychotherapy
Having in mind that the main cause for enuresis nocturna are psychogenic factors, it appears that the therapy that aims directly at the goal is psychotherapy.   Of all adults that the child knows, it trusts the most to its mother.

The mother is the best healer for her child! Maternal caress is the best medicine!

The mother tells the child in advance that in the evening, when it is asleep, she will come to it, she will caress its head and without waking it up she will say something to the child that will help it recover more quickly. When the child falls asleep, she will enter quietly in the room, she will approach slowly the child and put her hand over its head, being careful not to wake him up. If it happens that the child is not deeply asleep or wakes up during the visit, the mother puts her hand on his eyes saying quietly: “Pretty, you are getting wet because you sleep very deeply. From now on you will not sleep so deep and will feel when you want to go to the toilet. Then you will get up and you will go to the toilet.Then you back to bed and immediately fall asleep. From now on it will be like this! “

Drug therapy

Taking psychotropic medication to raise the tonus of the center of urination and products of belladonna, which reduce the muscle tonus of the bladder are drastic and extreme measures. Similar products have severe side effects on a child’s health and physics. Such treatment of enuresis nocturna should be undertaken only by qualified specialists and this is in the case when all other possibilities have been exhausted!

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