{"id":99,"date":"2017-03-23T07:48:08","date_gmt":"2017-03-23T07:48:08","guid":{"rendered":"http:\/\/papergp.com\/index.php\/nocturnal-enuresis\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"nocturnal-enuresis","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/paediatrics\/nocturnal-enuresis\/","title":{"rendered":"Nocturnal enuresis"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Differential diagnosis<\/h4>\n<ul>\n<li>Primary\n<ul>\n<li>Neurological problems<\/li>\n<\/ul>\n<\/li>\n<li>Secondary\n<ul>\n<li>Diabetes<\/li>\n<li>UTI<\/li>\n<li>Constipation<\/li>\n<li>Excessive fluid intake<\/li>\n<li>Psychological<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flags &#8211; frequency\/thirst\/weight loss, previously been dry<\/li>\n<li>Others &#8211; \u00a0daytime wetting, fluid intake, dysuria, bowels, social stress, general (growth, pregnancy, birth, development)<\/li>\n<li>Examination &#8211; height, weight (centile chart), abdo, urine dip<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Bedwetting diary<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Explanation\n<ul>\n<li>urine stretches the bladder as it fills, when it stretches to a point, the nerves send a message to the brain saying it needs to be emptied, if the child is asleep, the brain does not hear the message but the bladder empties anyway.<\/li>\n<li>Different reasons include infection, constipation, fizzy drinks, psychological factors<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Lifestyle\n<ul>\n<li>Patient reassurance &#8211; remind the child it is not their fault and not to be punished<\/li>\n<li>Avoid fizzy\/caffeinated drinks before bedtime<\/li>\n<li>Go to toilet before bed &#8211; reward system<\/li>\n<li>Leave bathroom light on at night<\/li>\n<li>Waterproof mattress cover<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Refer enuresis clinic\n<ul>\n<li>Bed wetting alarm &#8211; teaches child to wake and go to toilet before bladder is full<\/li>\n<li>Desmopressin &#8211; reduces amount of urine made at night, offered if over 7yrs old or for short term improvement<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Follow-up \/ Safety net &#8211; come back if not improving<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Primary Neurological problems Secondary Diabetes UTI Constipation Excessive fluid intake Psychological &nbsp; Data gathering Red flags &#8211; frequency\/thirst\/weight loss, previously been dry Others &#8211; \u00a0daytime wetting, fluid intake, dysuria, bowels, social stress, general (growth, pregnancy, birth, development) Examination &#8211; height, weight (centile chart), abdo, urine dip &nbsp; Clinical management Investigations Bedwetting diary Explanation &hellip; <a href=\"https:\/\/papergp.com\/index.php\/paediatrics\/nocturnal-enuresis\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Nocturnal enuresis<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":96,"menu_order":84,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-99","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/99","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=99"}],"version-history":[{"count":9,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/99\/revisions"}],"predecessor-version":[{"id":1953,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/99\/revisions\/1953"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/96"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=99"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}