Enuresis in children. Causes and treatment of symptoms: day, night. Folk remedies, medicines, drugs in tablet, doctors' recommendations

With enuresis in children faced by many parents. Up to a certain age, incontinence is not considered a disease and does not require special attention. But what if the child is old enough, and the situation does not change. Later in this article will be described in detail the causes of and treatment of children enuresis.

Features symptom

Enuresis (incontinence) predisposed almost all children under 5 years of age. Under such conditions, the phenomenon is not considered abnormal, just a child has not been fully worked out control over the functioning of the bladder. Disease, this condition is considered, if the child has passed the five-year mark, difficulty with urination do not disappear.

In this case, please consult with the experts and the appropriate treatment of the disease.

Classification

Enuresis in children (causes and treatment will be discussed in detail below) is divided into several types and degrees. The classification depends on how much self-control is adjusted over urination and whether there is any disease-causing urinary incontinence.

1. Primary. Characterized by a complete absence of the "dry" nights. Usually by age three children almost fully formed control over the functioning of the bladder. They can wake up in order to ask for the toilet. This type of enuresis almost always requires treatment, and completely disappears by 5 years.
2. Secondary. It characterized by the presence of "dry" and "wet" periods. The break is up to six months, and then returned to incontinence. Secondary enuresis occurs on the background of psychological and neurological problems.
3. Monosemeiotic. With this type of bedwetting show no comorbidities. Usually it goes through as they grow older.
4. Polisimptomny. Accompanied by problems with the psyche and health. Get rid of this kind is possible only with the help of medication.
5. Day. This type of enuresis occurs only during sleep during the day, overnight at the same time continue to remain "dry".
6. Night. The most common type of child enuresis. As a rule, it passes to the age of five.
7. Mixed. A distinctive feature is the lack of control over urination at any time of the day. Is most often age-feature and runs as they grow older.

In addition to the above types of enuresis is divided into several levels:

• easy when a child wakes up wet of not more than 1 time per night, but a total of only 3 times in three days;
• average (up to 5 "missteps" for the night);
• severe when a child urinates more than 6 times in a dream.

Until what age is considered normal?

In the absence of central nervous system diseases and other problems with health, bedwetting disappears by 5 years. Deviation from the norm, this condition shall not be considered if the child over this age rarely happens incontinence at night. Should worry if the child is of school age regularly wakes up in a damp bed. In this case it is necessary to consult a doctor and get a complete examination.

Causes of

Officially diagnosed with "bedwetting" is placed by specialists when the child reaches 5 years. At this age it ends with the formation of bladder control. disease factors can be different in boys, girls and adolescents. common causes of bedwetting also exist.

General:

• Heredity (if Mom and Dad suffered in childhood from this disease, with a probability of 80% in children, it too will be);
• CNS diseases;
• back injury and stomach;
• cerebral palsy;
• infections of the bladder and urinary tract;
• mental illness;
• birth defects;
• neurotic disorders;
• allergy accompanied by skin rash;
• hormonal disorders;
• diabetes;
• intrauterine growth retardation;
• hypothermia;
• not correct accustom the baby to the pot (important for children up to 3 years);
• deep sleep.

Boys:

• disruption of the endocrine glands;
• hormonal balance;
• gender predisposition (boys disease is diagnosed more often);
• heredity;
• glomerulonephritis;
• emotional disorders;
• back injuries and abdominal cavity.

Girls:

• Weak pelvic floor muscles;
• Age features;
• inherent characteristic of the CNS;
• cystitis;
• pyelonephritis;
• psychological problems (stress);
• injury.

Adolescents:

• trauma;
• neuroses;
• depression;
• hormonal imbalance.

Symptoms and signs

The main symptom is a manifestation of enuresis incontinence at any time of the day (night and day).

Symptoms in which the disease is suspected, may be:

• developmental delay (physical and mental);
• mental illness:
• schizophrenia;
• autism;
• mental retardation;
• epilepsy.
• hyperexcitability;
• increased motor activity;
• emotional instability;
• trouble sleeping and going to sleep.

Children who have problems with urination, have the same behavioral and psychological portrait.

They exhibit a tendency to:

• tantrums;
• mood swings;
• hyperactivity;
• difficulties in going to sleep.

It is also often observed in these children meteozavisimost.

Diagnostics

Enuresis in children, causes and treatment, which will help to identify the doctor, is a medical condition that requires examination at several experts.

Consultation will need to be obtained from the following physicians:

• pediatrician;
• urologist;
• neurologist;
• psychiatrist;
• endocrinologist.

Analyzes which will appoint experts to establish the source of the disease - a common blood and urine analysis, biochemical analysis of blood and urine.

In order to establish the correct diagnosis in the survey also includes:

• US kidney and bladder;
• ukrodinamicheskie;
• endoscopy;
• X-ray;
• electrophysiological studies.

tactics of treatment

One of the main methods of treatment of enuresis are non-drug methods:

• organization of the daily routine;
• the selection of diet;
• the desire of the child;
• various trainings to improve the functioning of the bladder;
• technique "awakening schedule";
• installation of conditioned reflexes.

When enuresis, complicated concomitant diseases, prescribe medication.

It includes:

• Drug treatment;
• fizioterepiya;
• Motivational;
• psychotherapy.

To obtain a positive effect, experts recommend to combine several types of treatment.

Diet and daily routine

Proper diet and daily routine can help to adjust the work of the bladder, to eliminate the psychological problems, facilitate falling asleep and normalize night's sleep. Diet for enuresis intended to limit fluid intake in the evening.

You will also need to remove from the menu of products enhancing uropoiesis:

• spicy and spicy food;
• soft drinks and juices;
• cranberry juice and lingonberry;
• coffee;
• cocoa;
• watermelon;
• apples;
• milk drinks;
• tea.

The last meal should be at least 3 hours before bedtime.

Recommended diet consists of:

• cereals (rice, millet, buckwheat);
• eggs;
• cheese;
• butter;
• natural juices;
• Dried fruit compote;
• of bread;
• products rich in vitamin C.

What should be included in the daily routine with enuresis:

1. morning exercises;
2. drinking regime in the afternoon;
3. limiting TV watching and video games to 1 hour per day;
4. going to bed and rising at the same time;
5. sleeping on an orthopedic bed.

physiotherapy

Physiotherapy uses different methods of treatment - psychotherapy, medication and non-drug. Noticeable effect in enuresis therapy have indicated in the table below procedure.

Title	Act
LFK	A set of exercises is chosen depending on the cause of enuresis.
Magnetic field (application)	Myorelaxation and has anti-inflammatory effect.
acupuncture	It provides quick positive effect, easily tolerated by children of any age.
Laser therapy	Normalizes the functioning of the central nervous system and bladder.
Thermal treatments (paraffin bath)	Warm paraffin wraps superimposed on his stomach in the bladder area of ​​location, to relax smooth muscles of his.
electrophoresis	It combines the introduction of certain muscles medicines and the effects of direct electric current.
inductothermy	It has antispasmodic, anti-inflammatory, analgesic effect.
Galvanization	It eliminates pathological impulses sensitive nervous system.
Ultrasound	It improves the functioning of the nervous system and the work of the bladder.
diadynamic	Through sensors attached near the bladder sphincter is its stimulation current of different frequencies.
electrostimulation	Trains and strengthens the muscles of the bladder.

psychotherapeutic techniques

Psychotherapeutic techniques have a huge positive effect in the treatment of children enuresis. Preferably before you start working with them to create a relaxed welcoming environment at home, organize a daily routine and diet.

Psychologists and therapists recommend the following techniques:

• dolphin therapy (Adjusts the nervous and immune systems, and restores metabolism);

• hippotherapy (Hyperexcitability decreases, resulting in a normal emotional background);
• art therapy (Normalizes the central nervous system develops fine motor skills, helps in the diagnosis of mental disorders);
• autogenic training (Help to eliminate the violations in the emotional sphere, relieve anxiety and depression);
• conversation with a psychologist (Normalize emotional state, eliminate the psychological causes of disease);
• hypnosis (Adjusts the nervous system to function properly, it will help to learn to control the muscles of the bladder during sleep);
• behavioral psychotherapy (Corrects behavioral abnormalities).

Psychological problems, causing a disease can be different:

• unfavorable situation in the family;
• problems communicating with their peers;
• the lack of attention from parents;
• jealousy in relation to other family members (brothers, sisters).

Parents should pay attention to the above reasons, and in the presence eliminate them.

Traditional medicines

Enuresis in children, causes and treatment, which every parent should know, can be eliminated as with traditional medicine. it is desirable to use the recipes in combination with traditional methods for the full and rapid recovery from urinary incontinence.

Infusion of yarrow, and thyme

Recipe:

1. Yarrow and thyme in proportions of 1: 1 to make 100 ml of water.
2. Drink 1 tablespoon 1 times a day.

salty food

We need bread and salt, or a piece of salted fish to eat in 30 minutes. before sleep.

ginger compress

To prepare you need:

1. Grate the ginger root on a grater.
2. Squeeze through cheesecloth.
3. The resulting juice is mixed with 100 ml of water.
4. Soak in a solution compress tissue.
5. Applied to the lower abdomen to the skin redness.

hardening

For the procedure, you must:

1. Pour into a shallow pan of cold water.
2. Resemble in water for 10-15 minutes.
3. Rub the legs with a towel warming up.
4. The procedure is best done after a night's sleep.

Massage wet cotton wool

For the procedure, you must:

1. Soak a piece of cotton wool with warm water.
2. Conduct wool along the spine a few times.
3. After the baby to wear pajamas and put to bed.

Before applying the recipes of traditional medicine is recommended to consult a pediatrician and to test for allergic reactions.

Special exercises

Gymnastics incontinence in children help strengthen the pelvic floor muscles and urinary sphincter. Perform exercises are best outdoors. No special equipment for gymnastics required.

The complex of exercises:

1. Walking. The duration of 1 min. When the heel of the left foot to rearrange the toe of the right and vice versa.
2. Standing on his toes. 4 sets. Each approach to 5 scores. After exercise lightly shake each leg.
3. balance retention. 6 approaches. Sit on a chair, his feet brought together. On account of 1,1, 3 to pull the chair seat. On the count of 4 to shake hands and relax.
4. Shoals. 11 approaches. Position - lying on his back. The heel of the left foot to place on his right knee, right foot on the floor. Make rolls from heel to toe. Repeat with the other leg.
5. Bicycle. Position - lying on his back. The duration of 1 min. Simulate cycling.

Massage

One of the most effective types of massage is considered to be a point when enuresis. It can help you not only to strengthen the muscle groups responsible for urination, but also the nervous system. In the treatment of this kind should be taken into account that requires an expert it is for baby massage.

Complex movements:

1. Measure the distance in 3 fingers below the navel, there is the first point. Intense massaging circular motion for about 1 min., Gradually decreasing rate.
2. The second point is a little lower at the top of the pubic bone. Massaging 4 min., The same as the first.
3. Turn the child on the stomach, from the bottom of the lumbar measure the distance to 1.5 toe in the side. Simultaneously massaged one point, accompanying circular motion pressings.
4. Retreat from the previous point another 1.5 finger and repeat the movement.
5. The latter point is located in one side of the finger base coccyx. Massaging the same as the previous one point.

medication

Enuresis in children, causes and treatment, which explains the expert, can be remedied by using only medications drugs. All other methods are only attendant, helping to speed up the healing process.

• Primary enuresis treated using preparations containing vasopressin. The most popular drug on the basis of this hormone is Minirin.
• With increased bladder tone prescribe medications to relieve muscle tension - Driptan, Minirin.
• Under reduced muscle tone of the bladder using injections of the complex preparations - with Minerinom neostigmine.
• Enuresis neurotic origin treated with the following medications - vitamins B, nootropil, New Passito, Persenom and other sedatives.
• When following a variety of infections, antibiotics may be prescribed bladder: Supraks, Flemoksin Soljutab.

operative therapy

Surgical treatment of incontinence in children is carried out rarely, only in the case of congenital abnormalitiesSuch as not imperforate urethra wall. Also resort to surgical intervention is necessary, if a child is injured bladder.

What you can not do?

There are a number of prohibitions, which must adhere to the treatment of child enuresis was effective.

Do not:

1. start treatment on their own, without examination by a doctor;
2. scold the child;
3. use hypnotic techniques in the home;
4. call the Child;
5. prevent hypothermia;
6. putting the child to sleep on a soft bed;
7. give to drink plenty of fluids before going to bed;
8. allowed to watch TV and play computer games before bed;
9. feed the baby acidic and spicy foods.

The opinion of Dr. Komarovsky

Enuresis in children popular children's doctor Komorowski assessed not as a pathology, you want to treat. He does not recognize the urinary incontinence in children as a separate disease. According to the doctor - it is only an epiphenomenon of other diseases. Primary enuresis according Komarovsky does not require any intervention, since it runs as the child grows.

There are no age limits in this case does not establish a physician, because he believes the skills of control of the bladder individual characteristics of the child. The main component of a successful cure bedwetting doctor thinks their parents' help in overcoming this disease.

According to Komarovsky parents must provide the child the maximum psychological support, not concentrating while his attention on the problem. Also, the doctor insists that only a strong desire and motivation of the child ensures fast and 100% result.

Komorowski strongly against the drug treatment of enuresis until the age of seven.

The main methods of treatment of this disease for children of any age, he said:

• motivational therapy;
• Bladder training;
• proper drinking regime;
• urinary alarms.

Motivational therapy is recognized as a doctor one of the most effective. This method is in the creation of the motivation of the child to wake up dry. It includes bans and promotion.

For example, a child wants some kind of toy, the parents offered him to "earn" it. To do this, he needs to wake up a few days in a row in a dry bed. Motivational therapy helps to get rid of urinary incontinence in 4-6 months.

Bladder training should include elements of motivational therapy, that is, the child himself should be willing to train. This method is that if you want the child to go to the toilet should be patient for 5 minutes. For each successful workout should be followed by the promotion, and each weekly period ends a pleasant surprise or a gift.

Urinary alarms recognized by Dr. Komarovsky as one of the effective methods in the treatment of enuresis. The main condition for the use of this device lies in the fact that the child has to control it himself.

As soon as the alarm goes off, it should stand on their own and go to the toilet, and then replace the sensor and go to bed. If parents intervene in the process, the device will be ineffective.

Also, the doctor recommends that you install the drinking regime of the day for a child. It consists in obtaining sufficient amount of liquid during the day, with the restriction in the second half. It is necessary to completely eliminate from your diet foods that contain caffeine (tea, coffee, chocolate, etc.), because they have a diuretic effect.

Sleeping baby needs a warm pajamas in the ventilated room. The absence of a dry hot climate in the baby's room will eliminate hunger before going to bed and dream that will also help him to wake up in a dry bed.

Treatment of enuresis in children can be effective only if, when eliminated all its causes. Doctors recommend comprehensive approach in addressing this disease, which includes medication and non-drug therapies.

Video of enuresis in children, its causes and treatments

When and how to treat enuresis:

Tips for treatment by specialists: