What are natural treatments for bed-wetting?

Introduction

Nocturnal enuresis, or bed-wetting, is defined as unintended
nighttime urination in a child who is older than five years of age. In most cases,
there is no underlying medical cause, in which case the condition is called
primary nocturnal enuresis (PNE). When enuresis occurs as a result of another
illness, it is called secondary nocturnal enuresis.

The adult bladder that becomes full during the night signals to the brain that this has occurred; in turn, the brain informs the bladder not to empty and also begins the process leading to wakefulness. The ability to carry out this process is not present at birth, but most children gradually develop this capacity and achieve it in full by age six years. However, as many as 7 percent of ten-year-olds and 1 to 2 percent of fifteen- year-olds continue to have trouble. Nearly all children with primary nocturnal enuresis will cease bed-wetting by the time they reach puberty. However, PNE remains a problem for up to 1 percent of adults.

Enuresis occurs more commonly in boys than in girls. In addition, there is a strong genetic predisposition: If both parents have enuresis, there is a 75 percent chance that a child will; this decreases to 40 percent if only one parent has enuresis.

Nocturnal enuresis is not a disease, but it can lead to significant embarrassment and limitation of activities, and for this reason treatment may be desired. The first step is a medical examination to rule out rare underlying causes, such as infection. Commonsense steps follow, such as not drinking much liquid near bedtime and urinating just before going to bed. More specific treatment can be delayed as long as desired, because in the great majority of cases, nocturnal enuresis will eventually disappear. For older children who wish to accelerate the process, nighttime alarm systems that wake the child in response to moisture in the child’s underwear are often highly effective. Other methods include bladder exercises and a schedule of planned nighttime waking. If these behavioral methods fail, the use of various medications may be considered.

Proposed Natural Treatments

Many parents turn to alternative medicine for the treatment of nocturnal enuresis if behavioral methods do not work. However, no alternative therapies have been proven effective for this condition.

Hypnosis has shown some promise for nocturnal enuresis. In
one study, fifty children were given the drug imipramine or given hypnotherapy
for three months. The results showed substantial and approximately equal benefits
in the two groups. Subsequently, children in the hypnosis group practiced
self-hypnosis for another six months, while those in the imipramine group did not
utilize any special therapy. At the end of the six months, children practicing
self-hypnosis had maintained their benefits to a much greater extent than those in
the imipramine group. Other studies found benefits with hypnosis too; however,
these studies had significant design limitations. Overall, the evidence supporting
hypnosis for nocturnal enuresis is not strong.

It has been suggested that food allergies may play a role in
nocturnal enuresis. However, there is only incomplete evidence that allergen
avoidance or any other dietary approaches can help.

Herbs used for miscellaneous bladder problems are often recommended for nocturnal enuresis, on general principles. These herbs include juniper, lobelia, marshmallow root, parsley root, and uva ursi. However, there is no evidence that these herbs help the condition, and some, such as uva ursi, may have toxic properties, especially when given for the long term.

Acupuncture, bach flower remedies, and Chinese
herbal medicine are also sometimes recommended for nocturnal enuresis, but there
is no reliable evidence that they are effective. One reasonably well-designed
study found evidence that a special form of chiropractic
(the activator technique) is not effective for bed-wetting. A small preliminary
study suggested that the use of pulsed magnetic stimulation day and night for two
months may be helpful in girls.

Herbs and Supplements to Use Only with Caution

Various herbs and supplements may interact adversely with drugs used to treat nocturnal enuresis, so persons should be cautious when considering the use of herbs and supplements.

Bibliography

Banerjee, S., A. Srivastav, and B. M. Palan. “Hypnosis and Self-Hypnosis in the Management of Nocturnal Enuresis: A Comparative Study with Imipramine Therapy.” American Journal of Clinical Hypnosis 36 (1993): 113-119.

But, I., and N. M. Varda. “Functional Magnetic Stimulation: A New Method for the Treatment of Girls with Primary Nocturnal Enuresis?” Journal of Pediatric Urology 2 (2006): 415-418.

Egger, J., et al. “Effect of Diet Treatment on Enuresis in Children with Migraine or Hyperkinetic Behavior.” Clinical Pediatrics 31 (1992): 302-307.

Mellon, M. W., and M. L. McGrath. “Empirically Supported Treatments in Pediatric Psychology: Nocturnal Enuresis.” Journal of Pediatric Psychology 25 (2000): 193-214.

Reed, W. R., et al. “Chiropractic Management of Primary Nocturnal Enuresis.” Journal of Manipulative and Physiological Therapeutics 17 (1994): 596-600.