Enuresis (Urinary Incontinence)
ENURESIS can be defined as bed wetting, which is frequently seen in childhood and is a recurring involuntary urine leakage during sleep in children over the age of five. Enuresis is divided into two; bed wetting at night and bed wetting at night, as well as a sudden urge to urinate during the day, frequent urination and daytime incontinence.
In order for a child to be diagnosed with enuresis, the chronological age must be at least 5 years old. Enuresis is seen to occur more frequently in boys than in girls. The factors that cause it are thought to be genetic, familial, psychological and environmental factors, sleep disorders, bladder-related factors and hormonal disorders. Enuresis is a condition that can cause significant psychological problems in children if left untreated.
The disease can cause excessive stress in the child, negatively affecting psychosocial development, and can also prevent children from developing self-confidence and socializing. Therefore, enuresis in pediatric patients should be handled very carefully and the factors that trigger the disease and prevent its recovery should definitely be reviewed. Factors that trigger urinary incontinence include family history, the time to start toilet training, the family's attitude towards nocturnal enuresis, home conditions, school and lesson motivation, and sleep patterns. The family's attitude plays an important role in these. When we look at the treatment of enuresis; various methods are seen; these are drug treatment, alarm system, calendar keeping method and various behavioral treatments.
Encopresis (Inability to Hold Feces)
ENCOPRESSIS can be defined as the recurrent, mostly involuntary, sometimes intentional, defecation in inappropriate places. This condition is a bit more problematic than urinary incontinence. In order for this diagnosis to be made, the child must be over 4 years old and this condition should not be due to the side effects of another medication or another disease. When the causes of encopresis are examined, physiological, psychosocial and environmental factors are seen, as in enuresis.
First of all, bowel control may not have been acquired at all due to inadequate toilet training or insufficient response to this training. In addition, although physiological bowel control is normal, there may be reluctance and resistance to the rules regarding defecation in appropriate places, usually due to a mental disorder. This situation may arise from a conflict between the parent and the child regarding toilet training or from stool retention due to painful defecation. As a result of physiological incontinence, incontinence and defecation in inappropriate places may be observed due to the accumulation of intestinal content. It is thought that children who have not completed toilet training or who refuse to sit on the toilet may have a more difficult temperament, and that difficult temperament may lead to bowel control problems.
In addition to difficult temperament, it is known that challenging life events and parent-child conflict are also associated with encopresis. Considering this information, it is thought that behavioral problems will be common in children with encopresis, and that their mothers will have higher anxiety levels. It is thought that the child's difficult temperament characteristics may lead to conflict between parents and children and problems with toilet training. Encopresis is a stressful condition for the child and the family because it is a chronic and recurring disorder. It is seen that anxiety, depression, attention and behavioral problems are common in children with encopresis, and their academic success is lower than other children. In its treatment, as in enuresis; medication and behavioral treatments are used, the calendar method may be recommended, and eliminating problems and tensions within the family may reduce the symptoms.
