chil­dren

The Star Malaysia - Star2 - - HEALTH -

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-

tory

Man­age­ment

der tion,

ment

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.

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