Incontinence in Children
Incontinence, or bedwetting, is the involuntary release of urine without control. This condition can occur two to three times a week, either during the day or at night while sleeping. There are two types: primary enuresis and secondary enuresis. The primary form occurs in children who have never achieved consistent bladder control, while secondary enuresis affects those who have previously been dry for six months or longer. This issue often troubles young children and can create confusion for their families. Research indicates that incidence rates are higher in boys, with the number affected being double that of girls in the same age group. Additionally, the prevalence of enuresis decreases with age, and for some, it may persist until the age of twelve.
Causes of Incontinence
The causes of enuresis can vary from one child to another, including:
- Psychological factors, such as lack of attention from caregivers or jealousy over a new sibling’s arrival.
- Genetic factors, particularly if one or both parents experienced similar issues during childhood.
- Physical conditions, including urinary tract infections, reduced bladder capacity, tonsillitis, type 1 diabetes, or intestinal worms, such as pinworms, which can infect children who do not wash fruits and vegetables properly. These worms can lead to irritation in the anal area, resulting in incontinence or constipation.
- Consumption of foods and beverages that contain methylxanthines, like tea or chocolate, which act as diuretics and increase urine production.
- Cognitive developmental disorders that make it difficult for the child to recognize the need to use the restroom, including conditions like Down syndrome and hyperactivity.
- Deep sleep patterns that prevent the child from feeling the urge to empty their bladder.
Treatment for Incontinence
Treatment for enuresis typically involves two approaches: behavioral therapy and medication. Behavioral therapy is often considered the most effective method because relying on medication can introduce side effects and approximately 80% of children may revert to bedwetting symptoms once treatment is discontinued. It is important to understand that behavioral therapy may take several months to show results, while medication effects can be seen within about two weeks.
Behavioral therapy focuses on educating parents about the nature and causes of the condition, guiding them to seek appropriate treatment based on the underlying causes. It is crucial to avoid reprimanding or embarrassing the child as a disciplinary approach, as this can exacerbate the problem. Medication, typically involving a synthetic antidiuretic hormone, should only be prescribed after consultation with a healthcare professional.