Adult bed wetting or nocturnal enuresis is believed to be relatively rare. It has been estimated that less than 1% of people between the ages of 18 and 64 experience the problem. However, the condition may be under-reported.
A survey conducted in the US indicates that parents of children over the age of 6 would be uncomfortable initiating a discussion about the problem with their child’s doctor. Another conducted in Australia indicated that 70% of adults with urinary incontinence had not spoken to their doctors about it.
Other surveys have had similar results. People do not always tell their doctors about bladder control issues. So, the incidence of adult bedwetting may be higher than we think.
35% of women over the age of 60 have bladder control problems. 50% of men over the age of 50 have symptoms of enlarged prostate. Either of those conditions could easily be responsible for adult bed wetting.
Recent research indicates that most adults with nocturnal enuresis had bladder control issues as children. This leads researchers to believe that the problem may be caused by a dysfunction of the urinary tract or the sphincter muscles that control urination. A bladder that is smaller than normal or overactive could also be to blame.
The problem might be genetic. Scientists believe they have identified unique chromosomes associated with nocturnal enuresis.
Photo: Simon Cataudo
Insufficient production of the anti-diuretic hormone (ADH) could also be the cause. ADH is also known as vasopressin. It plays a role in memory, circadian rhythms and blood pressure regulation.
Normally, the body produces and releases more ADH at night. This sends a signal to the kidneys to decrease urine production. Maximum production of ADH should be seen by the age of 10. This is one of the things that doctors can treat.
The prescription drug DDAVP or Desmopressin is a synthetic replacement for ADH. Use of the drug must be closely monitored, because it has been known to cause serious electrolyte imbalances. That being said, it is one of the more effective treatments for adult bedwetting.
Like many other hormones, vasopressin is composed of amino acids. Humans derive amino acids from protein-containing foods. Therefore, inadequate protein intake could lead to decreased production of ADH. Poor nutrient intake plays a role in many health problems, particularly in elderly patients, that can lead to adult bed wetting.
Doctors usually discuss the patient’s lifestyle and look for underlying health problems that could be the cause of urinary incontinence before prescribing drugs. Lifestyle factors that could be involved include caffeine or alcohol consumption and drug use.
Caffeine and alcohol cause increased urine production. Consumption of other liquids is not believed to have an effect. A number of prescription and non-prescription drugs can cause increased urine production as a side effect.
Examples of health problems to look for include enlarged prostate, diabetes and daytime urinary incontinence. Addressing those underlying health problems may be effective for resolving the nocturnal enuresis.
Genetics is likely to blame for adult bed wetting when a person had the problem during childhood and experiences it two or three times per week in their adult lives. Other factors are likely involved in people that stayed dry for many years.
Adult bedwetting is a subject that should be discussed. If you are a person with day or nighttime bladder control issues make an appointment with your healthcare practitioner. If you are currently taking a prescription medication, talk to your pharmacist about known side effects.
If you are a healthcare practitioner, talk to your patients about urinary incontinence. Keep brochures and pamphlets in your office to encourage your patients to talk to you.
Adult bed wetting may be embarrassing and difficult to discuss. Effective treatments are available. Good doctor/patient communication can ensure that people get the help they need.
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