Merck Manual

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Some Causes and Features of Nighttime Incontinence in Children

Some Causes and Features of Nighttime Incontinence in Children

Cause

Common Features*

Tests†

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)

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

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

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

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

Stress§

A doctor’s examination alone

Recording the timing, frequency, and volume of urine in a journal (voiding diary)

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)

* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present.

† 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.

‡ Diabetes does not typically cause incontinence until blood sugar (glucose) levels are high enough to cause glucose to enter the urine.

§ Stress is a cause primarily when incontinence is sudden.

MRI = magnetic resonance imaging.