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VUR kya hai
Peshab kidneys mein banta hai aur do patli nalion, ureters, se neeche bladder mein behta hai. Aam tor par jahan har ureter bladder se milta hai wahan aik chhota aik taraf wala valve peshab ko wapas oopar behne se rokta hai. Vesicoureteric reflux (VUR) mein yeh valve theek se band nahi hota, aur kuch peshab kidney ki taraf wapas behta hai, khaas tor par jab bacha peshab karta hai.
VUR aam tor par kisi baby ya bachay mein peshab ke infection ke baad, ya hamal ke dauran scan mein soojhi hui kidneys nazar aane ke baad pakra jata hai. Bohat se bachay ise bare hone par chhor dete hain. Asal maqsad bachay ke barhne ke dauran kidneys ko infection aur nuqsan se bachana hai. Yeh guide walidain ke liye hai. Yeh batati hai ke yeh kaise pakra jata hai, kaise sambhala jata hai, aur fauran madad kab lein.
Yeh kisi ki ghalti nahi. VUR walidain ke kisi kaam, saaf karne ke tareeqe, khurak, ya peshab rokne se nahi hota.
Yeh kitna aam hai
VUR kisi baby ya bachay ko baar baar peshab ke infection hone ki aam wajohat mein se aik hai, aur yeh khandan mein chal sakta hai. Yeh chhote bachon mein zyada pakra jata hai. Kuch bachon mein halka reflux hota hai jo kabhi koi masla nahi karta, aur kuch mein zyada wazeh reflux hota hai jis par qareeb se nazar rakhni parti hai.
Yeh kyun hota hai
Zyadatar bachon mein ureter ke bladder se milne ki jagah ka valve chhota ya kamzor hota hai, is liye woh kas kar band nahi hota. Yeh aksar paida hone se hota hai aur bachay ke barhne aur ureter ke lambe hone ke saath behtar hota jata hai. Kuch bachon mein reflux bladder ke masle, jaise bladder ka theek se khali na hona, ya neeche kisi rukawat ki wajah se hota hai. Qabz bladder ke masle aur infection ko mazeed kharab kar sakta hai.
Yeh kaise nazar aata hai
VUR wale bohat se bachon mein koi nishani nahi hoti. Jab nishaniyan aati hain to woh aam tor par peshab ke infection ki hoti hain:
- Bukhar, kabhi kisi aur alamat ke baghair, khaas tor par babies mein.
- Peshab karte waqt dard ya jalan, ya baar baar peshab aana.
- Pait ya peeth mein dard.
- Dhundla ya badboodar peshab.
- Babies mein: doodh na peena, ulti, thakan, chirchirapan ya wazan na barhna.
- Dry rehne ke baad dobara wetting, ya din mein accidents.
Jis baby ya bachay ko bukhar ho aur koi wazeh wajah na ho usay peshab ka infection ho sakta hai. Meherbani karke intezar na karein. Usi din peshab ka test karwayein.
Tashkhees kaise hoti hai
Aap ka doctor aam tor par:
- Peshab ka test karega infection ki tasdeeq ke liye, aur us ka ilaaj karega.
- Kidneys aur bladder ka ultrasound likhega. Yeh be-dard hai aur dikhata hai ke kidneys ya ureters soojhi hui hain ya nahi.
- Zaroorat ho to bladder ka X-ray test (micturating cystourethrogram, ya MCUG) likhega. Bladder mein aik patli naram nali dali jati hai, khaas dye daali jati hai, aur bachay ke peshab karte waqt X-ray tasveerein li jati hain. Is se pata chalta hai ke peshab wapas behta hai ya nahi aur kitna. Yeh takleefdeh hai lekin jaldi ho jata hai, aur bacha dard mein nahi chhoda jata.
- Kabhi kidney scan (DMSA scan) likhega kidneys par nishanat dekhne ke liye.
- Blood pressure aur nashonuma check karega, kyunke kidney ke nishanat baad mein in par asar daal sakte hain.
Meherbani karke poochein ke kya bhai behnon, khaas tor par babies, ki bhi jaanch honi chahiye, kyunke VUR khandan mein chal sakta hai.
Ilaaj ke tareeqay
Ilaaj is par mabni hai ke reflux kitna hai, bachay ki umar, infection hote hain ya nahi, aur kidneys par nishanat hain ya nahi.
Meherbani karke doctor ke baghair dawai ki dukaan se antibiotics na dein, aur likhi hui antibiotics jaldi band na karein. Ghalat ya adhoora ilaaj infection ko saaf karna mushkil bana deta hai aur kidneys ko nuqsan pohancha sakta hai.
Ghar par aap kya kar sakte hain
Yeh qadam aap ke bachay ki kidneys ki hifazat mein madad karte hain:
- Apne bachay ko din mein kaafi paani peene aur baqaidgi se, rokay baghair, peshab karne ki hausla afzai karein.
- Qabz ka jaldi ilaaj karein. Khurak, reshe aur paani ke baare mein doctor se poochein.
- Larkiyon ko aage se peeche ki taraf safai sikhayein, aur genital hissa saaf aur khushk rakhein.
- Babies mein nappy aksar badlein.
- Agar aap ke bachay ko bachao ki antibiotic di gayi ho to bilkul waise hi dein jaise likhi gayi ho.
- Jab kaha jaye to apne bachay ko peshab ke tests aur check-ups ke liye le jayein, aur bukhar hone par hamesha.
Follow-up
VUR wale bachon ko baqaida follow-up ki zaroorat hoti hai, peshab ke tests, blood pressure, nashonuma ki jaanch aur kabhi dobara scans ke saath, jab tak reflux khatam na ho jaye ya bacha achhi tarah qaboo mein na ho. Meherbani karke theek lagne par bhi in visits ko na chhodein, kyunke kidney ka nuqsan khamoshi se ho sakta hai. Jin larkiyon ki kidneys bachpan mein zakhmi hui thin woh agar baad mein hamila hon to apne doctor ko batayein, taake blood pressure aur peshab check kiye ja sakein.
Fauran madad kab lein
Agar aap ke bachay ko in mein se koi bhi ho to usay foran apne qareebi hospital ke emergency department le jayein:
- Tez bukhar, kapkapi, ya bohat beemar lagna, peshab karte waqt dard ke saath ya baghair. Yeh kidney ka infection ho sakta hai.
- Baar baar ulti, ya paani na rakh sakna.
- Aisi baby jo bohat sust, dheeli, doodh na pee rahi ho, ya tez bukhar mein ho.
- Bohat kam ya bilkul peshab na aana, ya peshab mein khoon.
- Peeth ya pehlu mein shadeed dard.
Meherbani karke usi din doctor ko bhi dikhayein agar aap ke bachay ko bukhar ho aur koi wazeh wajah na ho, ya peshab ke infection ki nishaniyan wapas aayen. Peshab ka test aur jaldi ilaaj kidneys ki hifazat karta hai.
Aam sawalaat
Kya mera bacha ise chhor dega?
Bohat se chhor dete hain, khaas tor par halke reflux wale, jaise jaise ureter lamba hota hai aur valve waqt ke saath behtar kaam karta hai. Kuch ko lambe arse ke ilaaj ya operation ki zaroorat hoti hai. Aap ka doctor batayega ke aap ke bachay ke liye kya imkaan hai.
Kya reflux kidneys ko nuqsan pohanchata hai?
Pohancha sakta hai, zyadatar jab infection kidney tak pohanch jaye, kyunke infection nishanat chhor sakta hai. Isi liye bukhar aur peshab ke infection ka foran ilaaj, aur lambe arse ka follow-up bohat aham hain.
Kya mere bachay ko saalon dawai leni hogi?
Kuch bachay lambe arse tak bachao ki antibiotic lete hain, aur kuch ko iski zaroorat nahi hoti. Aap ka doctor baqaidgi se jaiza lega aur mehfooz hone par band kar dega.
Kya hamesha operation ki zaroorat hoti hai?
Nahi. Zyadatar bachon ko nahi hoti. Is par un bachon ke liye ghaur kiya jata hai jo ilaaj ke baawajood baar baar infection ke shikar hon, ya jin ka reflux zyada shadeed ho ya kidney par nishanat hon.
Kya maine apne bachay ki theek dekh bhaal na karne se yeh kiya?
Nahi. VUR valve ke banne ke tareeqe mein farq hai. Yeh aap ke kisi kaam ki wajah se nahi hota.
Kya mere doosre bachon ki bhi jaanch honi chahiye?
VUR khandan mein chal sakta hai. Meherbani karke doctor se poochein ke kya bhai behnon, khaas tor par babies, ka ultrasound hona chahiye.
Kya bistar geela karna reflux se juda hai?
Yeh saath ho sakte hain, aur bladder aur aanton ki aadaatein dono par asar daalti hain. Agar aap ka bacha bistar geela karta ya din mein accident karta ho aur peshab ke infection ho to meherbani karke doctor ko batayein. Bedwetting guide dekhein.
Kya hakeem ke nuskhay ya ghareloo ilaaj reflux theek karte hain?
In ke theek karne ka koi saboot nahi, aur reflux wale bachay ke bukhar ka ilaaj kabhi ghar par nahi karna chahiye. Meherbani karke doctor ko dikhayein aur jo kuch aap ne diya ho sab batayein.
What VUR is
Urine is made in the kidneys and flows down two thin tubes, the ureters, into the bladder. Normally a small one-way valve where each ureter joins the bladder stops urine from flowing back up. In vesicoureteric reflux (VUR), this valve does not close properly, and some urine flows back up towards the kidney, especially when the child passes urine.
VUR is usually found in babies or children after a urine infection, or after a scan done in pregnancy showed swollen kidneys. Many children grow out of it. The main aim is to protect the kidneys from infection and damage while the child grows. This guide is written for parents. It explains how it is found, how it is looked after, and when to seek urgent help.
It is nobody's fault. VUR is not caused by anything parents did, by wiping, by food, or by holding urine in.
How common it is
VUR is one of the more common reasons that a baby or child has repeated urine infections, and it can run in families. It is more often found in younger children. Some children have mild reflux that never causes any problem, and others have more marked reflux that needs closer watching.
Why it happens
In most children, the valve where the ureter joins the bladder is short or weak, so it does not shut tightly. This is often present from birth and tends to improve as the child grows and the ureter gets longer. A few children have reflux because of a bladder problem, such as a bladder that does not empty well, or because of a blockage lower down. Constipation can make bladder problems and infections worse.
How it shows
Many children with VUR have no signs at all. Signs, when they appear, are usually those of a urine infection:
- Fever, sometimes without any other symptom, especially in babies.
- Pain or burning when passing urine, or passing urine often.
- Pain in the tummy or back.
- Cloudy or bad-smelling urine.
- In babies: poor feeding, vomiting, tiredness, irritability or poor weight gain.
- Wetting after the child was dry, or daytime accidents.
A baby or child with a fever and no obvious cause may have a urine infection. Please do not wait. Ask for a urine test the same day.
How it is diagnosed
Your doctor will usually:
- Test the urine to confirm an infection, and treat it.
- Arrange an ultrasound scan of the kidneys and bladder. It is painless and shows whether the kidneys or ureters are swollen.
- Arrange a bladder X-ray test (a micturating cystourethrogram, or MCUG) if needed. A thin soft tube is passed into the bladder, a special dye is run in, and X-ray pictures are taken while the child passes urine. This shows whether urine flows back up and how much. It is uncomfortable but quick, and the child is not left in pain.
- Sometimes arrange a kidney scan (a DMSA scan) to look for scars on the kidneys.
- Check blood pressure and growth, because kidney scarring can affect these later.
Please ask whether brothers and sisters, especially babies, should also be checked, because VUR can run in families.
Treatment options
Treatment depends on how much reflux there is, the child's age, whether there are infections, and whether the kidneys are scarred.
Please do not give antibiotics from the chemist counter without a doctor, and do not stop the prescribed ones early. Wrong or incomplete treatment makes infections harder to clear and can harm the kidneys.
What you can do at home
These steps help to protect your child's kidneys:
- Encourage your child to drink enough during the day and to pass urine regularly, without holding on.
- Treat constipation early. Ask your doctor about diet, fibre and fluids.
- Teach girls to wipe from front to back, and keep the genital area clean and dry.
- Change nappies often in babies.
- Give preventive antibiotics exactly as prescribed, if your child has them.
- Take your child for urine tests and check-ups when asked, and always if they have a fever.
Follow-up
Children with VUR need regular follow-up, with urine checks, blood pressure, growth checks and sometimes repeat scans, until the reflux has gone or the child is well controlled. Please do not skip these visits even if your child seems well, because kidney damage can be silent. Girls who had scarred kidneys as children should tell their doctor about it if they later become pregnant, so that blood pressure and urine can be checked.
When to seek urgent help
Take your child to the nearest hospital emergency department straight away if they have any of the following:
- High fever, shaking, or looking very unwell, with or without pain when passing urine. This may be a kidney infection.
- Repeated vomiting, or cannot keep fluids down.
- A baby who is very sleepy, floppy, not feeding, or has a high fever.
- Passing very little or no urine, or blood in the urine.
- Severe pain in the back or side.
Please also see a doctor the same day if your child has a fever and no obvious cause, or if urine infection signs return. A urine test and quick treatment protect the kidneys.
Common questions
Will my child grow out of it?
Many do, especially children with milder reflux, as the ureter grows longer and the valve works better with time. Some need long-term treatment or an operation. Your doctor will tell you what is likely for your child.
Does reflux damage the kidneys?
It can, mainly when an infection reaches the kidney, because the infection can leave scars. This is why quick treatment of fever and urine infections, and long-term follow-up, are so important.
Will my child need medicine for years?
Some children take preventive antibiotics for a long period, and some do not need them. Your doctor will review this regularly and stop it when it is safe.
Is an operation always needed?
No. Most children do not need one. It is considered for children who keep getting infections despite treatment, or who have higher-grade reflux or kidney scarring.
Did I cause it by not looking after my child properly?
No. VUR is a difference in how the valve formed. It is not caused by anything you did.
Should my other children be tested?
VUR can run in families. Please ask your doctor whether brothers and sisters, especially babies, should have an ultrasound.
Is bedwetting linked to reflux?
They can occur together, and bladder and bowel habits affect both. If your child wets the bed or has daytime accidents with urine infections, please tell your doctor. See the bedwetting guide.
Do hakeem remedies or home cures treat reflux?
There is no evidence that they do, and a fever in a child with reflux should never be treated at home. Please see a doctor and tell them about everything you have given.