Children who have never been dry that is, those who have primary enuresis, may have difficult becoming dry in the midst of stressful life circumstances. Daily stress such as family conflict, problems at school, illness, or friction between the enuretic child and other children may precipitate a wet night. Also, children who have previously attained dryness may start wetting, that is, show secondary enuresis, after experiencing stressful life events, some of which are mentioned below.
A recent study showed that children who have four or more stressful life events in a year are two and a half times more likely to develop secondary enuresis than children who do not experience any stressful events. In addition the researches found that children who first gained bladder control after age five were more than three times more likely to develop a secondary enuresis, with out additional stress.
Children who attained bladder control after age five and experienced four or more stressful live events were eight times more likely to develop a secondary enuresis.
When a stressful situation develops, which could be as ordinary as the birth of a new sibling or a move to a new home, or as devastating as sexual abuse or the death of a parent, a child now dry at night but prone to wetting problems may begin to wet under new circumstances. Perhaps the child normally has mild deep sleep, a slightly small functional bladder capacity, some food sensitivities, and a mild bowel disturbances but does not wet. When she is exposed to new, stressful circumstances, perhaps a new school, or her parents' divorce, or the death of a pet, wetting may occur transiently. The transient episodes, however, may breed more wetting and lead to a renewed pattern of frequent wetting.
This phenomenon of spiraling illness may also be noted when a child with a urine infection develops more urine infections, or a child with a cold develops an ear infection, which then leads to bronchitis, an so on. Left untreated, the isolated wetting episodes may stop spontaneously, but isolated wetting events can become a habit even after the precipitating stress has disappeared. Some children do work out their stress, and yet the wetting habit persists. We can break this pattern of wetting not only by addressing whatever stressful circumstances remain, but also by dealing with all of the child's predisposing factors (deep sleep, small bladder size, food sensitivities, and bowel irregularity)
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