Bladder problems in children, including bedwettingBachon ke bladder ke masail, bistar geela karne samait

Yeh alamat kya hai

Bachay mukhtalif umar mein bladder par qaabu seekhte hain, aur din mein khushk rehna aam tor par raat ko khushk rehne se pehle aata hai. Masail mein raat ko geela karna (bistar geela karna), din mein geela karna, bohat baar toilet ki hajat, achanak hajat jis se bachcha bhaagta hai, peshab rokna yahan tak ke der ho jaye, peshab mein dard ya jalan, aur kamzor ya boond boond dhaar shamil hain.

Jo bachcha bara ho aur abhi tak khushk na ho, ya jo khushk tha aur dobara geela karne laga, us ki wajah par narmi se ghaur karna chahiye. Taqreeban har soorat mein wajah dhoondi aur madad ki ja sakti hai. Meherbani karke kabhi bachay ko saza, sharminda ya doosron se mawazna na karein. Geela karna susti ya bad-tameezi nahi hai.

Aam wajohat

• Qabz. Bachon ke bohat se bladder ke masail ke peechay yehi khamosh wajah hoti hai. Bhari aant bladder par dabao daalti hai, usay jaldi sikudne par majboor karti hai, aur theek se khaali hona mushkil bana deti hai. Bohat se walidain hairaan hote hain, kyunke bachcha roz hajat karta ho tab bhi qabz ka shikar ho sakta hai.
• Overactive bladder. Bladder ka patthay bohat jaldi sikudta hai, jis se achanak hajat, toilet ki taraf bhaagna, bethna ya taangein kaatna, aur kabhi rissna hota hai.
• Peshab rokna. Kuch bachay khelne mein masroof hone ki wajah se, ya school ke toilet ganday, door ya band hone ki wajah se jaana taal dete hain. Lambe waqt tak rokna rissne aur infection ka sabab ban sakta hai.
• Peene ki cheezein. Din mein paani ki kami, aur gas wale mashroob, chai, cola aur energy drinks bladder ko bigaad sakte hain.
• Peshab ka infection. Is se jalan, baar baar peshab, geela karna, pait ya peeth dard, bukhar aur tez boo wala peshab ho sakta hai. Shair khwar aur chhote bachon mein sirf bukhar, ulti, doodh na peena ya chirchirapan nazar aa sakta hai (dekhein urine infection guide). Baar baar infection ke liye scan chahiye (dekhein vesicoureteric reflux guide).
• Raat ki wajohat. Bachcha raat ko bohat peshab bana sakta hai, bladder chhota ho sakta hai, ya woh itni gehri neend sota ho ke jag na sake. Yeh aksar khandan mein chalta hai (dekhein bedwetting guide).
• Khushk hone ke baad nayi tabdeeli. Peshab ka infection, qabz, diabetes (pyaas aur zyada peshab ke saath), ya dabao jaise nayi school, nayi bahan ya bhai, khandan mein kisi ka bichhar jana ya bullying, sab geela karna wapas la sakte hain. Kam hi, kisi dare hue ya sahme hue bachay mein achanak tabdeeliyan is baat ki nishani ho sakti hain ke school ya ghar mein kuch ghalat hai, aur bachay ko aise shakhs ki zaroorat hai jis se woh mehfooz mehsoos kar ke baat kar sake.
• Nas ya banawat ke masail. Kam hi, geela karna reerh ya nason se (dekhein neurogenic bladder guide), ya peshab ki nalion ki banawat se hota hai. Jo bachcha toilet aam tarah istemal karne ke baawajood musalsal geela rahe, us ka maahir se jaiza zaroori hai.
• Larkon mein, kamzor ya boond boond dhaar, ya tang ya ghair-mamooli suraakh ka muaina zaroori hai (dekhein hypospadias guide).

Jaanch aam tor par kaise hoti hai

Doctor peene ki cheezon, toilet ki aadaton, bachcha kitni baar geela karta hai, kya jaldi, dard ya kamzor dhaar hai, hajat ki aadaton, khandani tareekh, neend, aur bachcha school aur ghar mein kaisa hai, ke bare mein poochhenge. Woh pait, peeth aur jinsi hisson ka muaina karenge. Aam iqdamaat yeh hain:

• Aik hafte ki diary, jis mein peene ki cheezein, toilet ke chakkar, geela hone ke daure aur hajat likhi jayein. Yeh aksar sab se kaam ka zariya hota hai.
• Peshab ka test, infection, shakkar ya khoon dekhne ke liye.
• Kidneys aur bladder ka ultrasound, aik mehfooz scan jis mein radiation nahi hoti, khaas tor par baar baar infection, din mein geela karne, ya jab kuch ghair-mamooli lage.
• Dhaar ka test aur bladder scan, bare bachay mein, yeh dekhne ke liye ke bladder kitni achi tarah khaali hota hai.
• Mazeed tests, maslan peshab karte waqt bladder ka X-ray, un bachon ke liye rakhe jate hain jinhein baar baar infection ya doosri khatre ki nishaniyan hon.

Ab kya karein

• Pur sukoon aur meherbaan rahein. Kabhi bachay ko saza, sharminda ya bhai, behan ya cousin se muqabila na karein. Taweez, desi nuskhay ya jari booti ke mix istemal na karein. Yeh kaam nahi karte aur sahi madad mein deri kar sakte hain.
• Doctor ko dikhayein agar geela karna naya ho, din mein ho, dard, bukhar ya baar baar peshab ho, ya bara bachcha abhi tak khushk na ho.
• Aik hafte ki diary rakhein jis mein peene ki cheezein, toilet ke chakkar, geela hone ke waqt aur hajat ho, aur isay saath layein.
• Din bhar baqaida peene ko dein, zyadatar paani, aur zyada tar paani shaam se pehle. Din mein "geela karna rokne" ke liye peene ko na rokein, aur gas wale mashroob, chai, cola aur energy drinks kam karein.
• Toilet ka rootin banayein, har chand ghanton baad aur khaane ke baad jana. Bachay ko aaraam se paon ke sahare baithne dein, waqt lene dein, aur jaldi na karwayein. Masroof bachay ko yaad dilayein.
• Qabz ka ilaaj karein. Zyada resha (daal, sabzi, phal, chokar wali roti), zyada paani, aur khaane ke baad baqaida toilet ka waqt dein. Agar yeh kaafi na ho, to doctor se poochhein ke kaun si qism ki dawai munasib hai.
• School se baat karein. Kahein ke bachay ko zaroorat par toilet jane dein, dekhein ke toilet saaf aur dastiyab hain, aur kapron ka aik aur jora saath rakhein.
• Koshish ki tareef karein, maslan rootin par amal, achhi tarah peena aur geele hone ke bare mein batana, sirf khushk dinon ki nahi.
• Saade paani se narmi se dhoyein, achhi tarah sukhayein, aur dheele cotton ke underwear pehnayein. Larkiyan aage se peechay ki taraf saaf karein. Larkon mein khaal ko zabardasti peechay na khainchein.
• Raat ke geela pan ke liye bachay ko sone se bilkul pehle peshab karwayein, waterproof cover istemal karein, aur alarm aur doosri madad ke liye bedwetting guide parhein.
• Maahir ko dikhayein agar din ka geela pan jaari rahe, infections baar baar aayein, bachcha musalsal geela rahe, ya kamzor dhaar ya peeth ya taangon ki alamaat hon.

Aam sawalaat

What this symptom is

Children learn bladder control at different ages, and being dry in the day usually comes before being dry at night. Problems include wetting at night (bedwetting), wetting in the day, needing the toilet very often, sudden urges that send a child running, holding on until it is too late, pain or burning when passing urine, and a weak or dribbling stream.

A child who is older and not yet dry, or who was dry and starts wetting again, deserves a gentle look at why. In almost every case, there is a reason that can be found and helped. Please never punish, shame or compare a child. Wetting is not laziness or bad behaviour.

Common causes

• Constipation. This is the quiet cause behind many bladder problems. A full bowel presses on the bladder, makes it squeeze early, and makes it hard to empty properly. Many parents are surprised, because the child may open the bowels every day yet still be constipated.
• An overactive bladder. The bladder muscle squeezes too early, causing sudden urges, rushing to the toilet, squatting or crossing the legs, and sometimes leaks.
• Holding on. Some children put off going because they are busy playing, or because the school toilets are dirty, far away or locked. Holding on for long periods can lead to leaks and infection.
• Drinks. Too little water in the day, and fizzy drinks, tea, chai, cola and energy drinks, can all upset the bladder.
• A urine infection. It can cause burning, frequency, wetting, tummy or back pain, fever and strong-smelling urine. In babies and young children it may only show as fever, vomiting, poor feeding or irritability (see the urine infection guide). Repeated infections need a scan (see the vesicoureteric reflux guide).
• Night-time causes. A child may make a lot of urine at night, may have a small bladder capacity, or may sleep too deeply to wake. It often runs in families (see the bedwetting guide).
• A new change after being dry. A urine infection, constipation, diabetes (with thirst and large amounts of urine), or stress such as a new school, a new baby, a family loss or bullying can all bring wetting back. Rarely, sudden changes in a frightened or withdrawn child can be a sign that something is wrong at school or at home, and the child needs a safe person to talk to.
• Nerve or structural problems. Rarely, wetting comes from the spine or nerves (see the neurogenic bladder guide), or from the way the urine tubes are formed. A child who is constantly wet despite normal toilet use needs a specialist's assessment.
• In boys, a weak or dribbling stream, or a narrow or abnormal opening, needs a check (see the hypospadias guide).

How it is usually investigated

The doctor will ask about drinks, toilet habits, how often your child wets, whether there is urgency, pain or a poor stream, bowel habits, family history, sleep, and how your child is doing at school and at home. They will examine the tummy, the back and the genitals. Usual steps are:

• A diary for a week, noting drinks, toilet visits, wet episodes and bowel motions. It is often the most useful tool.
• A urine test, to look for infection, sugar or blood.
• Ultrasound of the kidneys and bladder, a safe scan with no radiation, especially for repeated infections, daytime wetting, or when something looks unusual.
• A flow test and bladder scan, in an older child, to see how well the bladder empties.
• Further tests, such as an X-ray of the bladder while passing urine, are kept for children with repeated infections or other warning signs.

What to do next

• Stay calm and kind. Never punish, shame or compare your child with a brother, sister or cousin. Do not use taweez, folk cures or herbal mixtures. They do not work and can delay the right help.
• See a doctor if wetting is new, if it happens in the day, if there is pain, fever or frequency, or if an older child is still not dry.
• Keep a one-week diary of drinks, toilet visits, wet times and bowel motions, and bring it with you.
• Offer regular drinks through the day, mostly water, with most of the fluid before the evening. Do not hold back drinks in the day to "stop the wetting", and cut down fizzy drinks, tea, chai, cola and energy drinks.
• Make a toilet routine, with a visit every few hours and after meals. Let your child sit comfortably with feet supported, take time, and not be rushed. Remind a busy child.
• Treat constipation. Give more fibre (daal, vegetables, fruit, brown flour roti), more water, and regular toilet time after meals. If this is not enough, ask your doctor which medicine type is suitable.
• Talk to the school. Ask that your child may go to the toilet when needed, check the toilets are clean and available, and pack a spare set of clothes.
• Praise effort, such as following the routine, drinking well and telling you about a wet patch, not only dry days.
• Wash gently with plain water, dry well, and use loose cotton underwear. Girls should wipe from front to back. Do not force the foreskin back in boys.
• For night wetting, have your child pass urine just before bed, use a waterproof cover, and read the bedwetting guide for alarms and other help.
• See a specialist if daytime wetting continues, if infections keep coming back, if your child is constantly wet, or if there is a weak stream or back or leg symptoms.

Common questions