Enuresis (Bed Wetting)

What is Enuresis?

Enuresis is often called “bed-wetting,” since this scenario is most common. However, more accurately, it is the repeated urination into inappropriate places, which may be voluntary or involuntary, and can occur only at nights, only during the day, or at any time.

How is Enuresis Diagnosed?

• This disorder is diagnosed once the following are observed:
• The child is at least 5 years old (or equivalent developmental level).
• There’s repeated urinating into bed or clothes, intentionally or not.
• The repeated urination happens at least twice a week for 3 months or over.
• The presence of any substance or medical condition that can also cause unintentional urination (e.g. seizures) is ruled out.

Risk Factors

Things that put a child at risk of Enuresis include:

• Delayed or lax toilet training
• Stress
• Family History (Genetic factors)

Treating Enuresis

In some cases the disorder resolves on its own over time. However, in many cases, intervention in some form is necessary due to the disorder’s repercussion on aspects of the child’s life.
Steps in any treatment plan include:

• Careful assessment
• Education of the child and parents about aspects of the disorder
• Appropriate toilet training and corrective techniques
• Therapy
• Medication is considered in some cases

Encopresis

What is Encopresis?

While Enuresis refers to issues with urine, Encopresis (also called fecal incontinence or soiling) has to do with stool and is characterized by repeated passage of feces into inappropriate places. This act, as well, may be voluntary or involuntary and is more common in males (three to six times more likely) than in females.

How is Encopresis Diagnosed?

Similar to Enuresis, this disorder is diagnosed once the following are observed:

• The child is at least 4 years old (or equivalent developmental level).
• There’s repeated stooling into inappropriate places eg behind a chair or clothes done intentionally or not.
• It has happened at least once a month for 3 months or more.
• The presence of any substance (e.g. using laxatives) or medical condition that can also cause unintentional urination is ruled out.

Risk Factors

These risk factors may increase the chances of having encopresis:

• Chronic constipation
• Emotional issues
• Using medications that may cause constipation, such as cough suppressants
• Attention-deficit/hyperactivity disorder (ADHD)
• Autism spectrum disorder
• Anxiety or depression

Treating Encopresis

Prevention is key and can be done through appropriate toilet training and avoiding constipation.

Nevertheless, since most cases have multiple interacting factors and causes, a comprehensive assessment of the child’s physical and mental health, as well as their social and environmental setting is necessary to guide proper care. So early treatment from the child’s physician ans/or mental health professional can help prevent the social and emotional impact of this disorder.