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For Parents

What is Bedwetting?

Bedwetting or Nocturnal Enuresis it has two types:
Primary type = where the patient did not get dry or get rid of bedwetting since birth till the present time.
Secondary type = whereby the patient has been dry for a period of time longer than 6-12 months then started bedwetting.

Is bedwetting a disease? a psychological disorder? or can it be considered both a disease and psychological disorder?

In my opinion, bedwetting is a disease which must be treated, at the same time a psychological disorder has to be ruled out and must be corrected.
Bedwetting can be like a mirror which may reflect to the outside and internal problem which is taking place in the body. For example reflux
A patient who is having a urinary tract infection ( UTI ) can present with bedwetting. Example : reflux

A child with congenital malformation of his urinary system since birth without being corrected once he gets older will also present with bedwetting.

Bedwetting can also be reflected from patients who have spinal cord problems, affecting innervation of the bladder (neurogenic bladder).

Bedwetting can cause a psychological problem that needs to be dealt with. This patient might come to a state of depression and self isolation to hide him self from others and avoid being daily blamed.

These children also do not participate in many activities. They cannot go for vacation, sleep in their friends or relatives home for fear of bedwetting, which leads again to self isolation.

Treating bedwetting will depend on factors such as age of the patient, underlying cause (congenital or psychological) of the problem.

Yes in some conditions it can be having pure psychological origin specially in secondary type of bed wetting.

Home Instability: divorce, fight between parents or new baby born to the family, death of beloved, child abuse.
School Instability: new teacher, punishment, loss of school mate.

Treatment :

Depends on the causes of bedwetting:

In the secondary type : where psychological origin is there Paediatric psychologist should be involved, social worker and the paediatrician to help in solving the problem and bring stability to patient life.

In primary type : where a congenital defect is there in the urinary system. Paediatric nephrologist diagnoses the cause and tries with cooperation with Paediatric surgeon or Urologist to solve the underlying cause. Even team work is sometimes needed to help child and family. Paediatrician, Paediatric nephrologist , Paediatric surgeon, Psychologist and social Worker.

Fever in children

Is fever a disease? or a symptoms of a disease?
Does fever means to start antibiotics?

Fever is a physiological process or reaction of the body which takes place when the body is fighting a foreign body. Foreign body can be anything that was ingested or acquired by accident ( i.e. piece of wood or metal, coin, etc. ) or it could be in case of an infection, a virus or a bacteria.

A virus or bacteria has a protein molecule which our immune system will recognize as a foreign body, so our body starts its defense system by fighting against this bacteria or virus. As a result of this fight, temperature will rise up. Fever then is an indication that defense mechanism in our bodies is active and alert.

If foreign body is other than bacteria or virus, the first thing to do is to remove the foreign body first because it will cause inflammation to the surrounding tissues and can cause injury. Once removed only then can antibiotics be given to help our immune system to cure this inflammatory process which is causing the infection.

Normal body temperature ranges from 36.5 C to 37.5C, depending which site it is measured. Usual sites for taking the temperature is under the tongue, inside the ears, under the armpit or in the rectum (safest is from the ear).

As a conclusion, fever is not always treated with antibiotics. As fever is a reaction of the body from any kinds of injury or infection. Patient should seek medical advise for proper treatment once underlying cause is treated with appropriate medications, the temperature will go down and it will be back to normal. We normally don't treat fever with antibiotics but with fever dropping medication but we treat the underlying cause.
Fever can be treated if the underlying cause is properly treated and so long fever persist means still immune system is active to fight the foreign body.

Dr. Rozina's
Paediatric Clinic

For Parents

© 2021 Copyright www.drrozinaspaediatricclinic.com a Paediatric Clinic, Kuwait

Dr. Rozina's Paediatric Clinic

For Parents

© 2021 Copyright www.drrozinaspaediatricclinic.com a Paediatric Clinic, Kuwait

Dr. Rozina's
Paediatric Clinic