What is enuresis?
Enuresis, also known as "bed wetting", refers to a disease in which people over 3 years old urinate and let themselves sleep until they wake up. For example, enuresis of children under 3 years old is not morbid, because under 3 years old, if the brain urination center is not well developed, urination habits have not yet been developed. If you still can't control urination after 3-5 years old, it should be regarded as enuresis. Most of them happen at night, but they are rare during the day.
What are the symptoms of enuresis?
Enuresis patients are sleepy before bedwetting, and their families are forced to get out of bed. He often walks around here, standing there scratching his head, confused and at a loss. When his family calls him to urinate, he can't urinate or can't urinate. He often wets the bed after a short sleep. After wetting the bed, children are wet and cold all over, can't sleep well at night, are prone to fatigue during daytime activities, have no spirit in learning, and sometimes are scolded by others and laughed at by friends. Over time, their hearts have been seriously hurt, which makes the lively and talkative children become introverted, irritable and withdrawn. Becoming timid, enuresis is not a fatal disease, but it will affect the communication between children, affect their sleep, study and life, and affect their intellectual development. It is a hidden killer.
Common causes of bed wetting in children
1) Genetic factors One parent has a history of enuresis, and the probability of hereditary enuresis in children is 44%; If both parents have a history of enuresis, the genetic probability is 75%. This mainly happens among boys.
2) Diseases and physiological factors, such as urinary tract infection, kidney disease, local inflammation of urethral orifice, spina bifida, spinal cord injury, sacral nerve dysfunction, epilepsy, cerebral hypoplasia, and small bladder volume, can all cause enuresis, but the proportion of enuresis caused by diseases is small.
3) Mental factors include excessive fatigue and excitement when children play during the day; Strong mental stimulation, such as being frightened; Anxiety and nervousness after bed wetting, occasionally reprimanded by parents or even corporal punishment.
4) Improper urination habit training did not give children timely urination training. For example, some mothers use disposable diapers for their children for too long, so that children can't develop their own habit of controlling urination. There is no habit of telling children to pee in the middle of the night. Some careless mothers wake up their children at night and let them sit on the bedpan and pee while playing, but this is because the children just sit on the bedpan and don't pee, so it is not easy for them to associate peeing with sitting on the bedpan and form a reflection.
5) The child sleeps too much. Generally speaking, children who wet the bed sleep deeply at night, are not easy to be woken up, and even don't know about bed wetting. When there is urine in the bladder, the urine can't reach the brain in time during sleep, and the brain can't give a wake-up instruction in time, so some children often dream of looking for a toilet before wetting the bed at night.
6) Environmental factors include environmental mutation and climate change, such as cold. In addition, drinking too much water before going to bed can cause children to wet the bed.
Etiology and pathogenesis of enuresis Chinese medicine believes that
Etiology and pathogenesis of enuresis Chinese medicine believes that:
1) enuresis occurs in children with physical weakness, congenital deficiency of kidney-qi, bladder deficiency and cold, failure of gasification and dysfunction of water channel.
2) Spleen and lung qi deficiency, spleen can't disperse fluid to the lung, lung deficiency can't pass the waterway, bladder loses restraint function, and enuresis occurs.
3) It is also due to poor care and improper training of children. When children have urine, they often urinate anytime and anywhere, which will affect the storage of bladder, the formation of bladder urine reaction and the formation of urination habits over time. This is also one of the reasons for enuresis.
4) In addition, there are people who do not urinate in time because of urination, which hinders bladder gasification. When urine stays for a long time, it will produce damp heat, which will also cause enuresis, especially for children aged 8-9.
The symptoms of enuresis vary from person to person:
Its symptoms vary from person to person:
1), the severity varies from once a week, or 1 month, to once a day, or several times a night to wet the bed. Poor health, fatigue, excessive excitement, tension and mood swings will aggravate symptoms; Sometimes it automatically decreases or disappears, and it can recur. About 30% of them have intermittent bed wetting, and some have continuous bed wetting for months and years. Children can gradually reduce the number of attacks and heal themselves within 3-5 years, some of which last until adolescence or adulthood.
2) Before wetting the bed, he was sleepy and it was difficult to wake up. His family forced him to get up. He often walks around here, standing there scratching his head, confused and at a loss. When his family calls him to urinate, he can't urinate or can't urinate. He often goes to bed for a while and then wets the bed. This matter "you said it was urgent!"
3) Children are usually prone to movement, sweating, emaciation, inattention and impatience.
4) Children have more enuresis at night than during the day, and most of them are in the middle of the night.
5) Most sleeping postures are crawling or squatting horizontally.
6) Some children are eccentric, irritable, inattentive, impatient, lack of self-confidence and timid.
7), enuresis is more serious in winter or rainy days.
Classification of enuresis
Enuresis can be divided into primary (functional) enuresis and secondary (organic) enuresis.
Primary (i.e. functional) enuresis: refers to enuresis caused by family inheritance, children's fatigue and too much sleep, or mental stress, or due to brain center and bladder and urinary nerve reflex dysfunction.
The so-called secondary (that is, organic) enuresis: refers to the child caused by some diseases of the acquired child. Such as: meningitis, epilepsy, brain trauma, spinal trauma, or diabetes insipidus caused by recessive spina bifida and enuresis caused by urinary malformation.
Diagnostic methods and treatment principles of enuresis in children
For patients with enuresis, we must first rule out systemic or local diseases and inquire about the medical history in detail, whether there are symptoms of urinary system infection such as urgency, frequent urination and dysuria; Understand the influence of family and school social environment on children and whether the methods and habits of training children to urinate are correct. General and perineal examination is also very important, including urine routine, urine sugar, middle urine culture, spine X-ray, kidney and bladder B-ultrasound examination, etc.
The symptoms of secondary enuresis can disappear after the treatment of the primary disease. The treatment of primary enuresis should first obtain the cooperation of parents and children, establish confidence and adhere to the functional training of holding urine and stopping urine. Guide parents to arrange a suitable living system (develop warm water to soak feet and apply navel before going to bed at night). Never scold, laugh at or punish a child when he has enuresis, otherwise it will increase his psychological burden. You should have a good rest at noon. In order to increase the bladder capacity, the urination time can be appropriately and intentionally prolonged. When urinating, try your best to drain it. After dinner, it is not easy to get excited. To urinate before going to bed, parents can wake up their children before the frequent enuresis time after they fall asleep, so that they can get used to urinating actively when they wake up.
Traditional western medicine treatment has many side effects, the curative effect is only 30-40%, and it is easy to relapse after withdrawal, so use it with caution. The general product imipramine hydrochloride is not used for children under 6 years old. Children over 6 years old should take it from 10ug/d to 1 hour before going to bed, gradually increasing to 25ug/d, and children aged 7- 10 can use 50ug/d.. Desmopressin: As an antidiuretic drug, it needs continuous treatment for more than half a year to reduce bladder urine volume, and it is easy to relapse after stopping taking the drug.