Bedwetting in older children and teenagers

What are the problems for older children and teenagers?
By Davina Richardson RGN/RSCN Specialist Children’s Nurse, Bladder & Bowel UK

Bedwetting or enuresis is one of the most common medical problems in the under 18s.  Those who wet the bed every night or nearly every night are less likely to ‘grow out’ of the problem.  Therefore, treatment should be offered to any child over the age of five years who continues to be wet for two or more nights a week.  Older children and teenagers may also be less likely to get better without treatment.

Bedwetting can be particularly difficult and distressing for older children and teenagers.  Embarrassment is a huge issue.  Feeling unable to share the problem with friends, due to fear of being bullied or laughed at, results in  isolation and young people avoiding social situations including sleepovers and school trips.  It causes problems with self-esteem and self-confidence and if sleep is disturbed can result in tiredness during the day.  All of these can improve with treatment.

If families do not understand that bedwetting is not deliberate, but is caused by a medical problem they might punish their child or young person. This can make the wetting worse, as well as cause more problems with low mood and distress.

Bedwetting is a medical problem and treatment is available.  Young people who have had treatment that has not worked may feel helpless and believe that this is a problem that will not get better. 

It is important that the young person and their family, understands

  • that bedwetting is a medical condition
  • that bedwetting is not their fault.  It is not caused by anything they have done or that they have not done
  • what causes of bedwetting
  • that treatments are available

Young people need to be included in consultations and understand the options for them.  Allowing them to be involved in choosing the right treatment for them, helps them to follow the treatment plan and makes success more likely.

Why do some people wet the bed?

Bedwetting happens when either the kidneys make too much wee while someone is asleep, or the bladder is not able to hold all the wee made during sleep.  Everyone who wets the bed does so because their brain is unable to wake them up in response to messages from their bladder. 

What can older children and teenagers do to help?

We know that some things can help bedwetting. These include:

  • Avoiding fizzy and caffeinated drinks (tea, coffee, hot chocolate, cola and energy drinks)
  • Drinking plenty of water-based drinks evenly spaced during the day. Teenage girls should be drinking 1.5 – 2 litres a day, and teenage boys should be drinking 2 – 2.5 litres per day
  • Avoid drinks and food for the last hour before bed, especially foods that contain a lot of salt or protein (these foods and drinks encourage the kidneys to make more wee)
  • Make sure you have a wee just before you settle to sleep
  • Try to go to bed at about the same time each night
  • Avoid constipation.  If you have a problem with your bowels (poos) tell your parent, carer or a health care professional – treatment is available for soiling (poo going in the pants), difficulty with pooing or not being able to poo for a few days or more at a time.  These problems can make wetting worse
What else can be done for bedwetting?

As there are different causes of bedwetting, there are different treatments.  If the bedwetting is happening because the kidneys are making too much wee at night, a medicine called Desmopressin might help.  If the problem is because the bladder is not able to store wee properly, then medicines known as anticholinergics might be the right treatment.  If the problem is that the bladder is too small, or the brain is not waking the young person up when the bladder wants to empty, then an enuresis alarm might work.  If there is more than one problem, there may need to be more than one treatment, so assessment is important.  Not all treatments are suitable for everyone.

Where can I get help?

Most secondary schools have a school nurse who runs a confidential drop-in clinic.  The reception staff at school should be able to tell you when this is, or give you the contact details for the school nurse.  They do not need to know why you want to contact the nurse.  School nurses may be able to offer advice or refer you to a specialist clinic.

Your GP (family doctor) or nurse at the surgery should also be able to give you advice or treatment, or refer you to someone who specialises in treating bedwetting. 

There is more information on the following website:
www.bladderandboweluk.co.uk

Bladder & Bowel UK have a confidential helpline at email: bladderandboweluk@disabledliving.co.uk or telephone 0161 607 8219

MN/XXXX/2019/UK
Date of preparation: August 2019

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