enuresis. These causes include bladder capacity, anxiety, and physical abnormalities of the urinary tract. from a distended lower bowel,
has constipation, and containing foods or drinks, that urine output, are other contribu-
ty, various management modalities They include no treatment, blad
medicines, dietary modificamoisture alarms.
of bedwetting in children spontaneously without any treat
child grows up. It has been that the incidence of bed reduces by 15% annually after the years. changes with the passage of an increase in bladder capaciof an overactive bladder, the production of ADH, the resolution provoking events, and the child respond to the signals that it is
training involves exercises that strengthen and co-ordinate the muscles. The child learns to the need to void and to control
there is no toilet nearby. methods used for nocturnal
include determining bladder capacity, drinking less before bed time, and having a routine for waking.
The methods used for diurnal enuresis include voiding according to a schedule, avoiding caffeine containing foods or drinks, and relaxing the muscles. There is, however, no guarantee of success with these bladder training methods.
There are medicines available to treat bed wetting. ADH levels can be increased with desmopressin, and an overactive bladder controlled with anticholinergics.
The medicine, imipramine, which acts on the brain and bladder, is used for short term treatment of nocturnal enuresis.
Moisture alarms awaken a person when voiding starts. The device has a watersensitive pad that is placed in the pajamas and is connected to a battery-driven control. An alarm goes off when moisture is detected on the pad. The child has to wake up when the alarm goes off and go to the washroom to void.
The use of such alarms may require another person to sleep in the same room as the child to awaken him or her.
Bedwetting is common in young children. It resolves spontaneously in most instances. The management modalities include no treatment, bladder training, medicines, dietary modification, and moisture alarms. Anyone whose child has bedwetting would benefit from a reassuring discussion with the doctor. n Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with. For more information, e-mail starhealth@ thestar.com.my.