Enuresis can be defined as bed wetting or clothes wetting in persons over the age of 3, who fail to inhibit the reflex to pass urine when the impulse is felt during waking hours and those who do not rouse from sleep of their own accord when the process is occurring during the sleeping state.
The study of enuretics by Psychiatrists, Psychologists, Paediatricians and Homoeopaths suggests that boys are more likely than girls to suffer enuresis. The ratio is 2:1.
Patients who are enuretic only at night are much less likely to have any associated or causative organic pathology. According to research 80% are nocturnal in their habit, while 15% of sufferers are diurnal and this group has max possibility of organic cause.
Causes of Enuresis:
DELAYED MATURATION of nervous system. FAULTY CONDITIONING if a child is punished for not using the potty when placed on it he will become conditioned against it and may refuse to use it.
FAULTY LEARNING may result from failure of mother to provide the child with an opportunity to empty the bladder when he first begins to announce the urge, he is liable to be retarded in acquiring control.
PSYCHOLOGICAL STRESS like unhappiness, insecurity, jealousy, excessive strictness, fright, grief, anger, nightmares.
SMALL BLADDER CAPACITY is sometimes one of the problems of the enuretic child.
WORMS infestation are common cause for bed wetting in children.
Organic Causes: SPINA BIFIDA or other LOWER SPINAL CORD LESIONS CONGENITAL ANAMOLIES of the GENITO-URINARY TRACT especially the urethral valve.CYSTITIS, TUBERCULOSIS or other infections of the urinary tract.DIABETIC ENURESIS may be an early symptom of diabetes.NOCTURNAL EPILEPSY may occasionally be accompanied by enuresis.PARALYSIS of BLADDER.WEAKNESS of the SPHINCTER VESICAE.
If an organic cause is suspected, proper clinical history should be followed by proper examination and investigations like BP, Blood Urea, Biochemical and Microscopic exam of urine, Intravenous Pyelogram and Micturating Cystogram may be required.
Management & Treatment:
A supportive attitude is required towards the patient in order to promote and sustain feelings of confidence and hope in the patient.
This method increases the bladder capacity. The patient is asked to withhold the urination for as long as possible. Hence the vesicle is trained and becomes adaptive in accommodating greater quantities of urine. At night the patient’s heightened threshold for retention eliminates the problem of bedwetting.
Waking the child to urinate during the night, this is helpful due to focused concern by the parents and the child, as well as to positive behaviorial reinforcement.
Depending on the symptomatology and case history a large number of medicines are available which have given effective results both during research as well as clinically. However homeopathic treatment must be taken under guidance of expert and competent homeopathic physician.
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