Some Causes and Features of Nighttime Incontinence in Children
Some Causes and Features of Nighttime Incontinence in Children
Cause |
Common Features* |
Tests† |
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Infrequent, hard, pebblelike stools Sometimes abdominal discomfort In children who consume a constipating diet (for example, excessive milk and dairy products and few fruits and vegetables) |
Usually doctor's examination alone Sometimes an x-ray of the abdomen Recording the timing, frequency, and volume of stool in a journal (stooling diary) |
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Developmental delay |
No daytime incontinence More common among boys and heavy sleepers Possibly family members who had wet the bed |
A doctor's examination alone |
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Increased urine output, which can have many causes, such as |
Vary by the disorder |
For diabetes mellitus, urine tests for glucose (sugar) and ketones and/or a blood test‡ For diabetes insipidus or sickle cell disease, blood tests |
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Sometimes in children who snore and have pauses in breathing during sleep followed by loud snorts Excessive daytime sleepiness Enlarged tonsils |
A sleep study test |
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Spinal defects (for example, spina bifida), leading to difficulty emptying the bladder (urinary retention) |
Obvious spinal defects, a dimple or hair tuft in the lower back, and weakness or decreased sensation in the legs and feet |
X-rays of the lower back Sometimes MRI of the spine |
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Stress§ |
School problems, social isolation or problems, and family stress (such as divorce or separation of the parents) |
A doctor’s examination alone Recording the timing, frequency, and volume of urine in a journal (voiding diary) |
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Pain while urinating, blood in the urine, the need to urinate frequently, and a sense of needing to urinate urgently Fever Abdominal pain |
Urinalysis and urine culture If urine culture and urinalysis results are positive and especially if kidney infection, possible ultrasonography and voiding cystourethrogram (x-rays taken before, during, and after urination) |
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* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. |
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† Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing. |
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‡ Diabetes does not typically cause incontinence until blood sugar (glucose) levels are high enough to cause glucose to enter the urine. |
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§ Stress is a cause primarily when incontinence is sudden. |
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MRI = magnetic resonance imaging. |
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