Remedies for Night Enuresis

Enuresis is the scientific term that indicates the loss of involuntary urine. When it happens during the night it is commonly called "bed pee".

It is a different disorder than urinary incontinence and pollakiuria.

Nocturnal enuresis is considered normal until the age of 5-6 years, age when (usually) urination control is achieved.

On the other hand, it is not uncommon for it to manifest itself until adolescence and it is estimated that it affects 1% of adults.

Peeing in bed causes quite significant psychological and social discomfort, especially in subjects in the post-pubertal age.

To be defined as such, nocturnal enuresis must:

Repeat and appear at least 2 times a week for 3 consecutive months
Interesting subjects over 5 years of age
Being independent of drugs and clinical conditions.

What to do

In case of nocturnal enuresis it is necessary to identify the triggering causes and act to reduce them or counteract their action.

First of all, it is essential to check the family history and any predisposition of parents or family members (grandparents, uncles, cousins, etc.).

Keep in mind that if a parent has had nocturnal enuresis, the child has a 40% chance of inheriting this tendency. If it concerns both, the odds rise to 70%.

In the event that the parents spontaneously solved the inconvenience, the forecasts are favorable; it's usually just a matter of time.

On the contrary, it is necessary to investigate the possible responsible causes. In particular:

Exclude a delay or "defect" in physical development, which may concern:

Insufficient bladder capacity. Keep in mind that sometimes it remains for life but that does not mean that the subject will continue to suffer from nocturnal enuresis. Diagnosis is made with ultrasound and specific test systems.
Underdevelopment of physiological alarms that indicate the need to urinate, measured with some neurological tests.

Understanding whether the production of urine during the night is excessive: this does not mean that it is a real disorder, but sometimes it can depend on the hormonal axis. It can be solved with small specific pharmacological doses.
Exclude the presence of obstructive sleep apnea: this disorder causes a decrease in circulating oxygen and can have serious consequences.
Reduce emotional problems: they are potentially responsible for nocturnal enuresis. At best, it is anxiety and general stress (removals, loss of a family member, disputes, excessive pressure, exaggerated commitment to study, work and sport, etc.). Sometimes however, the psychological root of bed-wetting concerns real traumas (mourning, scares, etc.).
If present, treat chronic constipation: the fullness of the colon occupies the space of the bladder, irritating it and diminishing sensitivity to urination.
In the case of a child, make him aware and help him understand the problem. It may be helpful to encourage them to pee regularly even during the day.
Moderate evening activities: nervous stimuli and some hormones such as adrenaline increase urine production and excretion.
Adjust the diet (see below).
Solicit to empty the bladder well before sleep.
Wake up or wake up the subject once or twice a night to urinate and / or use the diaper. These are devices that not all pediatricians share.

What NOT to do

The first rule is NOT to blame those suffering from nocturnal enuresis. As anticipated, emotional stress and certain psychological events can be the main cause. Further compromising the mood of those who pee in bed is likely to worsen the situation.
Avoid the practice of sports or late-night games.
Avoid going to bed at the end of your strength. Deep sleep is generally positive but in the case of nocturnal enuresis it plays an unfavorable role.
Avoid improper eating habits (see below).

What to eat

To avoid nocturnal enuresis it is advisable:

Dine about 3 hours before sleep.
Consume portions of medium size, without exceeding the total volume of the meal, which must be lower than lunch.
Prefer naturally hydrated foods, even if they are not necessarily dry.
Promote the intake of foods that do not require retention and subsequent production of urine; must have the following characteristics:

Little sodium.
Medium size index and glycemic load.
Absence of stimulating and diuretic molecules.

What NOT to Eat

We MUST AVOID:

Nutrition close to sleep.
Overdo the portions and the total amount.
Liquid foods: broths, purée, cups of milk, smoothies etc that increase urine production.
Too much fresh fruit and vegetables that increase urine production.
Very salty foods: they increase thirst and promote renal excretion after a few hours.
Sweetened products: they increase thirst and promote water retention immediately after a meal, which is eliminated after a few hours.
Diuretic products: increase renal filtration and nightly accumulation of urine.
Drinks containing stimulants: they also have a diuretic effect.
Drink more than a glass of water between dinner and sleep.

Natural Cures and Remedies

There are no natural remedies and treatments for primary or idiopathic nocturnal enuresis.

Pharmacological care

The pharmacological remedies against nocturnal enuresis are mainly:

Desmopressin: compensates for the lack of vasopressin hormone (ADH) responsible for reducing renal filtration during sleep. It must be taken by the child (starting from 9 years of age) just before the night rest. The most common form is the nasal spray. The only side effects that could occur are: nasal irritation and occasional headaches.
Imipramine: not recommended for children. It is a tricyclic antidepressant that also acts by relaxing the bladder and increasing its capacity. The side effects are different. It can be addictive.
Oxybutynin: is an anticholinergic also useful in muscle relaxation of the bladder. It is more suitable in diurnal enuresis.