Bed wetting or enuresis refers to the involuntary passage of urine during sleep. Nocturnal enuresis of children may be simply a delay in the establishment of voluntary control over the act of micturition.

Although wetting is normal in infants and children in the first twelve months, about 13% of 6-year-olds and 5% of 10-year-olds wet the bed. Most girls can stay dry by age six and most boys stay dry by age seven Any child having reached the age of 8 years and not having gained full nocturnal control must be subjected to complete investigations. The child itself only is not responsible as considered by the parents since it is beyond his control and if the case is taken up properly and all aetiological factors are taken into consideration the child can be cured.

Types – there are 2 types of enuresis.

Primary Enuresis : - Primary enuresis has an organic basis and common causes are

Secondary Enuresis :Common causes are:

Symptoms : These are usually self apparent; some children will sleep right through the night and still wet the bed while asleep while others will wake up and then wet the bed. There may be symptoms of itching in genitals or anus in some children.

Diagnosis : A detailed history along with thorough examination is essential to diagnose the case. All extrinsic causes having been excluded, a full urological investigation will be preferred including:

Coping with Bed wetting : Factors that affect the age at which wetting is considered a problem include the following:

Bedwetting usually goes away on its own. But until it does, it can be embarrassing and uncomfortable for your child. So it's important to provide support and positive reinforcement during this process. Following measure if adopted properly along with removal of the cause if any can be very much helpful in curing enuresis.

HOMOEOPATHIC TREATMENT OF ENURESIS

Due to organic causes

Causticum: Particularly in children during first sleep worse in winter and ceases or becomes more moderate in summer with great debility .

Belladonna: Children with blue eyes , light hair , fine complexion , restless sleep, involuntary urination consequent upon paralysis of sphincter muscles.

Rhus tox: Enuresis due to weakness of bladder with constant dribbling of urine.

Ferrum met: . As under change of composition of urine .

Sabal serrulata: Due to paralysis of sphincter ,constant desire to pass urine at night

Gelsemium: Due to paralysis of sphincter muscles , does not like to talk with any body .

Dulcamara: Enuresis after some disease of bladder, worse from cold and damp. The child desires different things ,but rejects on receiving them , copious turbid foul smelling urine .

Petroleum: Due to weakness of bladder, urine drops out even after urination, involuntary at night in bed .

Due to psychological causes

Kreosotum: Enuresis with dream of urination in a decent manner, wets the bed at night. A girl 16 years of age suffering from enuresis has been cured on the basis of this particular symptom.

Borax : Frequent urination at night, children who are frightened when being laid in a cot or carried down stairs.

Argentum nitricum: Great nervousness with restlessness, urine passes unconsciously and interruptedly, pale fetid urine, drinking coffee aggravates.

Sulphur : wetting bed at night, copious discharge of children who suffer from chronic cutaneous eruption.

Psorinum: Worse during full moon. Intractable cases, when there is an eczematous history. In children when there are Psoric manifestations. Secretions have filthy smell. The child is very sensitive to cold.

Constitutional basis :

Calcarea carb : complaints of children who are fat, fair and flabby too much emission of urination at night. Sour vomiting of children during dentition with a tendency to eat indigestible things such as chalk, pencils etc,

Medorrhinum : in children where there is a psychotic history nocturnal enuresis weak memory, fear in the dark as if some one is behind her/him.

Sepia : The sepia child is dull, depressed moody indolent with a greasy skin disinterested in work worse from change of weather. A tendency to diarrhoea from boiled mil, the child is prone to enuresis during the first sleep (Causticum).

Tuberculinum : Enuresis in a child with primary tuberculosis psychotic persons

Sulphur : for pale lean children with loose abdomen who love sugar and highly seasoned food and aversion to be washed, micturition midnight .

In young girls :

Pulsatilla—suited to cases of nocturnal enuresis occurring in children of tearful habit, conscious of its leakage but unable to control it. The urine passed drop by drop.

Kali phos : Enuresis in longer children due to nervous factors.

Calcarea carb : Scrofulous children sweat easily wetting the follow and catch cold easily.

Kali brom : Nocturnal enuresis from profound sleep of children or young persons.

Lac canium : As under psychological causes.

Opium : As under psychological causes

When without any apparent cause but due to more habit

Equisetum : Enuresis by day and night, it acts well when it remains a mere force of habit, after removal of the primary cause, dreams of seeing crowd of people

Due to defective digestion

Nux vom : Loves fats and tolerated them well , nausea in the morning after eating . Irritable bladder from spasmodic splinter, frequent calls little and often with dribbling of urine.

Carbo veg : when associated with acidity of the stomach

Iodine : Children eat too much but still emaciate all the time.

Change in urine composition

Benzoic acid: when enuresis is accompanied by high colored and strong smelling urine, Benzoic acid will turn the urine normal and prevent its escape.

Ferrum met : more in day time than at night. Floods the bed 5-6 times at night; stains the bed very dark and smell very strong. Clay colored sediment adhering to bottom of vessel.

Cubeba : urine foamy with smell of violets. Frequent urination due to some organic disease as uretheritis prostates.

Viburnum : urine of a foul odor like cat urine can not hold urine while walking

When due to worms

Cina: the chief remedy for worms. The child is very irritable useful for round and thread worms (not pin worms) urine turns milky on standing. Enuresis during first sleep, great appetite soon after leaving the table.

Silica : useful for children suffering from worms due to weakness of urinary organs

Santon ine : Especially useful for children suffering from ascaris, lumbricoids and thread worms and not tape worms, urine greenish if acidic and reddish if alkaline

Sepia: Incontinence of urine at night especially 1 st sleep the urine is very offensive and deposits a clay colored, sediment which adheres to the chambers.

Nat. mur : Hungry yet looses flesh , craving for salt , aversion to bread and fats , child emaciating from neck urine passing involuntarily when walking and coughing , has to weight a long time for it to pass if others are present .

“ Kreosotum” and “ Belladonna” – who sleep so deeply that they loose control of their bodily function. “ Sepia” wets himself during the first part of the sleep, while his days are spent tidying up in order to restore a sense of cleanliness and order.

“ Capsicum” has never recovered from a house move or other displacement.

Kali bichromicum : is trying to define his boundaries just like an animal marking its territory