Bedwetting is the most common pediatric problem and the causes are many. One of the most common causes of bedwetting is the delay in neurological development.
Causes of bedwetting
Bedwetting either can be primary nocturnal enuresis (PNE) or secondary nocturnal enuresis (SNE). The causes listed below are usually associated with primary nocturnal enuresis (PNE).
The nervous system may be slow in developing and may be slow in processing the sense of full bladder. The development of the endocrine function in production of antidiuretic hormone may be slow and urine may be produced at the same rate both in the day and night.
Genetic mark up also plays a big role and causes bedwetting in children. Children of parents who had bedwetting problems are at the high risk of bedwetting.
Lack of bedtime hygiene like urinating before going to bed and avoiding drinking too much liquids before bedtime can lead to bedwetting.
Secondary nocturnal enuresis
In secondary nocturnal enuresis (SNE), infections, diseases, physical abnormalities or psychological disorders may be the reasons.
Infections and diseases of the urinary bladder can lead to secondary nocturnal enuresis with impaired bladder control and increased chances of even daytime enuresis.
There can be urinary tract abnormality or smaller than normal bladder in some persons which causes secondary nocturnal enuresis. In many instances this type of physical abnormality can be corrected by surgical procedures.
In some children chronic constipation causes bedwetting due to pressure on the bladder. Use of diuretic medicines and chemicals, alcohol or caffeine increases the chances for secondary nocturnal enuresis.
The abnormal function of hypothalamus in production of preprohormone precursor or its storage in vesicles at the posterior pituitary can affect the production of antidiuretic hormone (ADH).
Insufficient production of antidiuretic hormone (ADH), Arginine vasopressin (AVP), can lead to uniform rate of production of urine both in the day and night which causes secondary bedwetting.
Psychological issues, especially in children, like death in the family, physical abuse or extreme ill-treatment may lead to secondary bedwetting in children.
Life stresses like moving to a new place, conflict in the family, divorce in the family, new school, newborn in the family or loss of pet can be the causes of bedwetting.
It is very likely that children with ADHD (Attention deficit hyperactivity disorder) show secondary bedwetting. Secondary nocturnal enuresis is one of the symptoms of pediatric neuropsychological disorder called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections).
Persons affected by sleepwalking in many instances also suffer from secondary nocturnal enuresis and may even urinate while sleepwalking. Obstructive sleep apnea (OSA), a condition characterized by abnormal pauses in breathing, sometimes causes secondary bedwetting.
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