Bedwetting, or nocturnal enuresis, is a vexing but common problem in children. Approximately one out of every five 5-year-olds and one out of 10 6-year-olds wet the bed, according to the American Academy of Pediatrics. The overwhelming majority of children with bedwetting have no underlying physical disorder. Their bodies and brains have simply not yet mastered the level of bladder control necessary to stay consistently dry throughout the night. Rarely, bedwetting may be caused by a physical condition.
Type 1 Diabetes
Type 1 diabetes mellitus occurs when the capacity to produce the hormone insulin is severely decreased or absent. Most commonly diagnosed in childhood, type 1 diabetes causes an array of symptoms, including increased appetite, extreme thirst, decreased energy, irritability and increased urine production. In a child who was previously staying dry through the night, the sudden onset of bedwetting, along with other characteristic symptoms, may indicate the onset of type 1 diabetes, notes the Mayo Clinic staff on MayoClinic.com.
Stool Holding and Constipation
Children can develop chronic constipation due to inadequate fiber or liquids in the diet, or because they refuse to have a bowel movement. Children may suppress the urge to move the bowels for a variety of reasons. Holding the stool and constipation can lead to an accumulation of feces in the rectum, which can encroach on the urinary bladder. The crowded bladder may lack the capacity to hold enough urine to keep a child dry through the night, resulting in bedwetting. In a 2008 article published in "American Family Physician," Dr. Kalyanakrishnan Ramakrishnan notes that wetting accidents associated with stool holding and constipation typically decrease significantly when the bowel problem is corrected.
Urinary Tract Infection
Urinary tract infections inflame the urinary bladder and urethra--the tube for passing urine from the bladder to the outside of the body. The irritated tissues cause characteristic symptoms, including urinary urgency and frequency. Wetting accidents, including bedwetting, in a child that was previously staying dry may be a symptom of a urinary tract infection, notes the National Institute of Diabetes and Digestive and Kidney Diseases. Other symptoms of urinary tract infection that point to this condition as a cause of bedwetting include fever, chills, irritability and pain or burning with urination.
Ectopic Ureter
The ureters are the tubes that connect the kidneys to the bladder. Each kidney normally has one ureter. Some children are born with an extra ureter that does not connect to the bladder. This condition, known as an ectopic ureter, may cause daytime and nighttime wetting in girls. The ectopic ureter usually drains near the vagina, causing a low level of urine leakage throughout the day and night, reports the American Urological Association on the patient information website UrologyHealth.org. Ectopic ureter is not typically a cause of urine leakage or accidents in boys.
References
- Healthy Children: Bed Wetting (Enuresis)
- MayoClinic.com: Bed-Wetting
- "American Family Physician"; Evaluation and Treatment of Enuresis; Kalyanakrishnan Ramakrishnan, M.D.; August 2008
- National Institute of Diabetes and Digestive and Kidney Diseases: Urinary Tract Infections in Children
- UrologyHealth.org: Ectopic Ureter
