Teen Boy’s Bedwetting Resolved with Homeopathy
Nocturnal enuresis (bed wetting) is defined by the National Institute for Health and Care Excellence (NICE) guidelines as involuntary wetting during sleep without any inherent suggestion of frequency of bedwetting or pathophysiology. It is considered normal up to the age of 5 years. Children with nocturnal enuresis may have excessive nocturnal urine production, poor sleep arousal, and/or reduced bladder capacity. Children with nocturnal enuresis may also have daytime urinary urgency, frequency, or incontinence of urine.
Definition:
Primary nocturnal enuresis. This is the recurrent involuntary passage of urine during sleep by a child aged 5 years or older, who has never achieved consistent night-time dryness. This may further be subdivided into:
- Primary nocturnal enuresis without daytime symptoms: children who have enuresis only at night.
- Primary nocturnal enuresis with daytime symptoms: those who also have daytime symptoms, such as urgency, frequency, or daytime wetting
Secondary nocturnal enuresis. This is the involuntary passage of urine during sleep by a child who has previously been dry for at least six months. Primary enuresis most often represents developmental delay which resolves in time. In secondary enuresis, the patient regresses after a period of continence, which requires the exclusion of underlying pathology - eg, a urinary infection.
Three etiological factors are commonly involved:
1. A disorder of sleep arousal. The child is not awakened by the sensation of a full bladder.
2. Bladder factors. There may be a low nocturnal bladder capacity and/or an overactive bladder. Emptying reflexes are not inhibited during sleep
3.Nocturnal polyuria. Affected children have been found to have low overnight vasopressin levels and excessive production of dilute urine during the night.
This is a case of a 15-year-old boy. At the age of seven, the patient began experiencing episodes of nocturnal enuresis after exertion from extended play hours, an outburst of anger, and after parental reprimands. The patient was registered in February 2022 (Patient ID-46520) at the Life Force Homeopathy Pimpri branch. He was bedwetting three to four times a week, 1-2 times at night, usually in the early morning. Four years ago, he had been treated with homeopathy, but there were no noticeable changes in his bedwetting complaint.
Past history: He had a right-hand fracture 4 years ago and had a history of chickenpox and dengue.
His case was studied in detail, and as per the case need, Dr. Rajesh Shah prescribed Causticum-30.
Advice was given to parents to encourage him to drink more fluids during the day and limit intake to 1-2 hours before bedtime. To ensure he uses the toilet before sleeping and, if needed, wake him once during the night for a bathroom visit. To avoid bladder irritants like caffeine and acidic foods in the evening. To establish a regular bathroom routine and provide emotional support, as bedwetting is involuntary and not the child’s fault. It was also suggested that using waterproof mattress covers and absorbent underwear can help manage accidents without stress.
Investigations:-
July 2022 USG: Abdomen and pelvis: No abnormality was present
Urine Routine:-PC and EC Occasional, Mild Protein was trace
Vitamin D was normal and Vitamin B12 was low, so for the same, additional supplements were prescribed and guided.
Follow-ups:-
In his first follow-up in April 2022, the frequency of urine was decreased 1-2 times a week, and his sleep was better.
By the second follow-up, which was taken in June 2022, there was a slight worsening in the condition; he had wetted a bed 5 times a week last month, but sleep was better.
In July 2022, when he gave his third follow-up, the symptoms were much better.
In September 2022, the symptoms of nocturnal enuresis were better, and the frequency of urine was also reduced.
By October 2022 the frequency of urine episodes had increased, and he was wetting the bed more often, on inquiry, the cause was not found. As per the case, the medicines were revised.
In November 2022, the severity and frequency of nocturnal enuresis decreased as compared to the last follow-up.
In his last follow-up dated December 2022, the patient had improvement overall and was stable; his recovery was sustained.
Conclusion:-
This case demonstrates homeopathic treatment can be a safe and effective option to address underlying causes like deep sleep, emotional factors, or bladder sensitivity in cases of nocturnal enuresis.
- Case study is written by Dr. Nagma Inamdar, Associate doctor to Dr. Rajesh Shah, MD (Hom)