What are the early symptoms of enuresis in children?

Children around 5 years old can control urination normally and basically will not wet the bed at night. So what is childhood enuresis? What are the early symptoms of childhood enuresis? What are the causes of childhood enuresis? How to treat childhood enuresis? What are the misunderstandings about the treatment of childhood enuresis? What are the folk remedies for the treatment of childhood enuresis? The following editor will introduce you in detail.

What is enuresis in children

Enuresis in children refers to a disease in which children over 5 years old cannot control their urination on their own, often urinate in their sleep, and wake up only after waking up. Clinically, it can be divided into primary enuresis and secondary enuresis. The former refers to continuous or persistent enuresis, during which the period of controlled urination has never exceeded one year; the latter refers to children who have controlled urination for at least 1 year, but then have enuresis again. Most cases of enuresis in children are functional. Its symptoms are related to factors such as daytime fatigue, family environment, and adaptability to the new environment. Reasonable arrangements for children's drinking water and training of children's urination are very important for children with enuresis.

Early symptoms of enuresis in children

1. The severity of the disease varies. In mild cases, bedwetting may occur once a week or once a month, and in severe cases, bedwetting may occur once a day or several times a night. Poor health, fatigue, overexcitement, tension, and mood swings can aggravate the symptoms. Sometimes the symptoms decrease or disappear automatically, but may recur. About 30% of people have intermittent enuresis, while others have persistent enuresis that lasts for months or years.

2. Before bedwetting, he is drowsy and difficult to wake up. When family members force him to get out of bed, he often walks here and there, scratches his head, and is confused and at a loss. When family members call him to urinate, he cannot urinate or cannot urinate completely. Often, he goes to bed and sleeps for a while, then wets the bed.

3. Children are usually restless, sweat a lot, are thin, lack concentration when doing things, and lack patience.

4. Enuresis occurs more often at night than during the day, and mostly in the first half of the night.

5. The sleeping position is mostly crawling or curled up.

6. Some children with enuresis have strange tempers, are irritable, have difficulty concentrating, or have poor endurance and confidence, are timid and introverted.

7. Enuresis often worsens in winter or on rainy days.

Causes of enuresis in children

1. Genetic factors. Nocturnal enuresis is usually dominant in the family. If both parents have been bedwetting patients, their children have a 3/4 chance of bedwetting. If one parent has been bedwetting patients, their children have a 1/2 chance of getting the disease. This is a very scary case. Parents, please discover it in time and treat it in time.

2. Disease factors. Pinworms (irritation of the urethra by the worms), urinary tract infection, kidney disease, local inflammation of the urethra, spina bifida, spinal cord injury, sacral nerve dysfunction, epilepsy, cerebral dysplasia, small bladder capacity, etc., but only a small proportion of enuresis is caused by disease. The vast majority of children's bedwetting is related to mental factors, hygiene habits, environmental factors, etc.

3. Very deep sleep. This type of children often play very hard before going to bed, sleep very deeply, are difficult to wake up, and often wet the bed in their dreams. If they drink a lot of water before going to bed, they are more likely to wet the bed.

4. Others. Some children have not received urination training, such as using diapers for a long time, parents do not wake up their children at night, carry them to the toilet to urinate, and some parents even help their children urinate while they are sleeping in bed, which makes children urinate in their sleep. Over time, it is easy to wet the bed at night.

5. The nighttime bladder control ability is underdeveloped. As patients with nocturnal enuresis grow older, their symptoms may improve and they may stop wetting the bed, but it may take several years to stop. Even 1% of people continue to wet the bed after entering puberty.

6. Environmental factors. A sudden change of environment; climate change such as cold weather, etc. In addition, children drinking too much water before going to bed; eating fruits such as watermelon that are high in water content and have a diuretic effect; parents not taking care of their children in time when they want to defecate at night, etc. can all cause children to wet the bed.

7. Insufficient urine control hormone ADH is not produced. In addition, 20-30% of children with nocturnal enuresis cannot produce enough urine control hormone ADH during sleep. Urine control hormone is a hormone produced naturally by the human body and can reduce the amount of urine.

How to treat enuresis in children

1. Behavioral therapy

(1) Set up a schedule

From the first day of treatment, ask the parents to set up a schedule for the child to record every day (you can use a calendar). When the child wets the bed, try to find the factors that may cause the bedwetting and record them on the schedule, such as not sleeping on time, being too excited before going to bed, being too excited during the day, and taking too much fluid in the evening. When the child does not wet the bed, draw a star on the schedule and give verbal praise or material rewards. Meet with the doctor once a week.

(2) Establishing conditioned reflexes

From the beginning of treatment, parents are required to use an alarm clock to wake up the child half to one hour before the child often wets the bed at night, so that the child can get up and urinate. The ring tone that wakes up the child and the stimulation of a full bladder are presented at the same time. After a period of training, the conditioned reflex is established, and the child can be awakened by the stimulation of a full bladder to achieve the purpose of self-control of urination. In addition, the child should be encouraged to urinate by himself, so that the child can urinate cleanly when he is relatively awake.

(3) Bladder function exercises

Urge the child to drink more water during the day and try to extend the interval between urinations to increase urine output and gradually increase bladder capacity. Encourage the child to stop urinating, count from 1 to 10, and then empty the urine in the middle of urination to improve the control ability of the bladder sphincter.

2. Western medicine treatment

Take clomipramine once a day, 1 hour before bedtime, continue taking it for 3 months after it takes effect, then gradually reduce the dosage, take it once every 2 days before bedtime, continue for 1.5 months, take it once every 3 days, continue for 1.5 months, and then stop taking it, the total course of treatment is 6 months.

A small dose of clomipramine is used in combination with treatment. Its mechanism of action is that the drug has an anticholinergic effect on the bladder, which expands the bladder capacity and stimulates the cerebral cortex, making the child easily awakened and get up to urinate. During use, it was found that some children may experience sleep disturbance, decreased appetite, and easy excitement at the beginning of treatment, which generally disappears on their own in about 1-2 weeks without treatment.

Misunderstandings in the treatment of enuresis in children

Children's enuresis can heal itself without treatment

Bedwetting after the age of 3 can be medically defined as enuresis, but some parents wait until the age of 6 or 7, or even until the teens, to take their children to treatment. Statistics show that the incidence of bedwetting is 0.5%-1.0% higher in children over 12 years old, indicating that many bedwetting patients cannot heal themselves. Clinically proven, late treatment will not only miss the best treatment opportunity, but also increase the difficulty of treatment and the cost of treatment.

Emergency use of drugs for enuresis in children

Being misled by advertisements to buy medicines from pharmacies on your own, or even abusing folk remedies and secret recipes, is not a big deal in terms of wasting money. The important thing is that not only does it delay the best time for treatment, but the abusive use of drugs may also have a great impact on the patient's body.

Ignoring the child’s psychological activities during treatment

Children who wet the bed may seem to be indifferent, but they are actually under great psychological pressure. If they don't wet the bed at night, the relief they feel in the morning will tell the whole story. Even in early childhood, repeated reprimands will put pressure on children who already feel guilty. Therefore, do not instill a sense of inferiority in children, do not bring a great mental burden to children, and over-stimulate children's sensitive nerves, leading to emotional instability, which will become an obstacle to their natural development. Therefore, the understanding of parents, families, schools, and society is very important. We must respect children's privacy and give them some self-esteem.

Treating enuresis in children requires urgency and speed

The fundamental reasons for children's bedwetting are, first, congenital deficiency, spleen and stomach disharmony, insufficient kidney qi, bladder failure and other organ dysfunction; second, the slow development of the central nervous system leads to the inability to accurately and timely transmit urination signals to the brain, or accompanied by a decrease in the secretion of antidiuretic hormone by the brain at night. Because it is a functional treatment, it takes a certain amount of time to completely cure it. However, many parents seek urgent and quick treatment, but haste makes waste, leading to repeated attacks.

Folk remedies for the treatment of enuresis in children

1. Children's urine-reducing syrup

【Source】Experience

[Ingredients] 10 silkworm cobs, 15g each of cornus fruit, oxyphylla, dodder seed, raspberry, 100g brown sugar

[Preparation] Add 500 grams of water to the above leaves, boil twice, take 400 grams of juice, add brown sugar and dissolve it in a bottle.

[Usage] Take 10 grams each time, 3 times a day.

【Effects】Tonify the kidney, restrain semen and reduce urination. Suitable for children with enuresis; also effective for adults with spermatorrhea.

[Dos and Don'ts] Enuresis due to liver heat is contraindicated.

2. Leek root juice

【Source】Folk Prescription

【Ingredients】25g leek root

[Preparation] Wash the leek roots, put them into clean gauze, squeeze out the juice, boil it and drink it while warm.

[Usage] Take twice a day for 10 consecutive days.

【Effects】It can invigorate the stomach and refresh the mind, warm the middle and promote the flow of qi. It can strengthen the yang. It is suitable for children with enuresis.

3. Pig Tripe Stewed with Ginkgo

【Source】Folk Prescription

[Ingredients] 15-30g ginkgo nut 1 pig tripe

[Preparation] First cut the pig's stomach and clean it, put the ginkgo nuts into the pig's stomach, put it into the pot, and stew it as usual; you can also simmer it and eat it.

[Usage] Take once a day for 3 consecutive days.

【Effects】Strengthen kidney qi and stop enuresis. Suitable for children with enuresis.

[Dos and Don'ts] Ginkgo nuts are slightly poisonous, so it is not advisable to eat too much at one time.

4. Gorgon Fruit and Cherry Seed Soup

【Source】Folk Prescription

[Ingredients] 50g Gorgon rice, 20g Rosa laevigata

[Preparation] First boil 100 grams of golden cherry juice, add water chestnut rice to cook porridge, and add appropriate amount of white sugar.

[Usage] Take twice a day, warm.

[Effects] Strengthen the kidney and reduce urine, nourish the kidney, consolidate essence and strengthen the spleen. Suitable for children with kidney deficiency and enuresis; can also be used for adult spermatorrhea and elderly urinary incontinence.