Some Causes and Features of Nighttime Incontinence in Children
Cause | Common Features* | Tests |
|---|---|---|
Infrequent, hard, pebblelike, or very large stools Sometimes abdominal discomfort In children who consume a constipating diet (for example, excessive milk and dairy products and few fruits and vegetables) | Usually doctor's examination alone Sometimes an x-ray of the abdomen Recording the timing, frequency, and volume of stool in a journal (stooling diary) | |
Developmental delay | No daytime incontinence More common among boys and heavy sleepers Possibly family members who had wet the bed | A doctor's examination alone |
Increased urine output, which can have many causes, such as
| Vary by the disorder | For diabetes mellitus, urine tests for glucose (sugar) and ketones and/or a blood test† For diabetes insipidus or sickle cell disease, blood tests |
Sometimes in children who snore and have pauses in breathing that last 15 seconds or more during sleep followed by loud snorts Excessive daytime sleepiness Enlarged tonsils, adenoids, or both | A sleep study test | |
Spinal defects (for example, spina bifida), leading to difficulty emptying the bladder (urinary retention) | Obvious spinal defects, a dimple or hair tuft in the lower back, and weakness or decreased sensation in the legs and feet | X-rays of the lower back Sometimes MRI of the spine |
Stress‡ | School problems, social isolation or problems, and family stress (such as divorce or separation of the parents) | A doctor’s examination alone Recording the timing, frequency, and volume of urine in a journal (voiding diary) |
Pain while urinating, blood in the urine, the need to urinate frequently, and a sense of needing to urinate urgently Fever Abdominal pain | Urinalysis and urine culture If urine culture and urinalysis results are positive and especially if kidney infection, possible ultrasonography and voiding cystourethrogram (x-rays taken before, during, and after urination) | |
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. | ||
† Diabetes does not typically cause incontinence until blood sugar (glucose) levels are high enough to cause glucose to enter the urine. | ||
‡ Stress is a cause primarily when incontinence is sudden. | ||
MRI = magnetic resonance imaging. | ||