Enuresis/Encopresis
Enuresis is the inability to control urination. Daytime wetting (diurnal enuresis) versus nighttime wetting (nocturnal enuresis) can sometimes indicate different types of problems.
Screening:
If your pediatrician has ruled out medical causes (e.g.,
bladder infection or anatomical abnormalities), the cause might be slow
development of bladder control. Enuresis may be the result of a small bladder capacity, deep
sleeping, or underdevelopment of sphincter muscle control. Enuresis due to slow development will gradually
improve as the bladder grows and muscle control develops.
Sometimes enuresis can be a sign of anxiety or stress when the body’s stress response systems interfere with normal bladder control, and that’s when a mental health professional can be helpful.
When to Refer
Enuresis is considered a problem beyond age of 4 years for daytime and beyond 6 years for nighttime, or loss of continence after three months of dryness. Most children develop bowel and bladder control by their fourth birthday.
Treatment:
Treatment for enuresis usually starts with behavioral
interventions if possible. This may
include scheduled trips to the bathroom, and reducing fluid intake before
bedtime.
Other interventions for enuresis might include moisture
alarms and medications.
Other interventions for encopresis might include enemas or
laxatives to clear out the bowels.
If enuresis or encopresis is due to anxiety or stress, then it usually responds to psychological treatment for the primary anxiety problem.
There are many easily-found resources on the internet for recommendations about enuresis and encopresis, but the professional investigation should start with your pediatrician.
If you are a provider who specializes in enuresis and/or encopresis, or know someone who does, please share that information with us by emailing [email protected]
Updated 9/23/2020