Traditional Chinese Medicine Perspective
Article Series: In TCM bedwetting relates to Kidney-qi weakness. The Kidney-qi governs the two yin – the anus and the urethra – and has an internal/external relationship with the Bladder. If the Kidney qi is weak then the lower burner will not be strong, and the two yin orifices will be unable to hold the fluids; hence the functions of storage and retention of fluids is impaired.
The situation is further aggravated because the Kidney qi is unable to support the Bladder qi, and its function of regulating the water passages fails as well. These two factors cause enuresis.
As well as this Kidney-qi weakness there are often other patterns associated with enuresis. Individual diagnosis is made for each child after detailed questioning. The following questions help to make this diagnosis:
- How much urine is passed during sleep?
- How often do they pass urine during the day and what is the colour, smell of the urine?
- Are they heavy sleepers?
- Does the child tend towards cold or hot, inattentiveness, nervousness, hyperactive in the evening or when overstimulated?
- Does the child catch colds easily; is the bedwetting worse when sick?
- Have they had recurrent infections requiring antibiotics?
- How would you describe the child emotionally? Are they easily distressed? Tantrums? Fearful?
- Does their bedwetting change when they are away from home?
Observations are made:
- Timbre of the voice is assessed
- Whether the child is overweight or skinny
- Tongue is observed
- Pulses are felt. These are usually a reliable indicator of what is happening
- Lymph glands in the groin and neck are felt (if indicated)
The underlying causes of bedwetting then are:
- Constitutional weakness (Research shows that bedwetting is likely to run in families)
- Long-term or severe illness
- Repeated coughs and colds
- Inappropriate use of medicines
- Inappropriate diet – too much damp and cold foods or spicy junk foods
- Constrained emotions (sometimes counseling can be recommended)
- Children should not be given anything to drink after 4pm and should empty their bladders before bed
- Appropriate diet should be recommended according to pattern
- Some factors in a child’s life tend to cause the qi to leave the lower burner and rise up to the head: school work, TV, computer games. These should be discouraged just before bed time.
- Emotional crisis – whether at school or home will aggravate or indeed cause the problem. Counseling may be a consideration.
- Pull-up disposable underpants are a short-term option and can be especially useful for hassle-free family holidays or if your child wants to go to sleepovers without the risk of wetting the bed. These can be used discretely, and may offer your child added self-esteem. It must be noted that while pull-ups may be convenient, they often do not solve the long-term problem!
Auckland Acupuncture Treatment
For some children (and parents!) the thought of acupuncture needles is too frightening. In these cases we can use a combination of moxibustion, acupressure and/or Chinese herbs to great effect. Parents are taught some basic acupressure techniques to do each night. Moxibustion is the burning of the Mugwort herb. It creates a warm and pleasant sensation and helps to tonify the Kid-qi. If the child can tolerate needles, very thin needles are used. Often needles are not retained, only placed in and out of the acupuncture points very quickly.
The time required to cure these children depends on the extent of the deficiency. In a reasonably strong child, three to four treatments will be sufficient, but in a weaker child, more will be needed.
Acupressure Helps Relieve Bed-Wetting
The authors assessed the efficacy of acupressure for treating nocturnal enuresis compared with oxybutynin (medication used to relieve urinary and bladder difficulties). Parents of twelve patients administered acupressure at acupuncture points Gv4, Gv15, Gv20, B23, B28, B32, H7, H9, St36, Sp4, Sp6, Sp12, Ren2, Ren3, Ren6, K3 and K5. Twelve control patients received 0.4 mg/kg oxybutynin. Parents were asked to record incidences of bed-wetting and patients and/or parents completed a questionnaire 15 days and one, three and six months after the start of treatment.
In conclusion, nocturnal enuresis can be partially treated by oxybutynin but acupressure could be an alternative non-drug therapy. Acupressure has the advantages of being non-invasive, painless and cost-effective.
Yuksek, M.S. et al. Acupressure versus oxybutynin in the treatment of enuresis. The Journal of International Medical Research 31(6): 552-6.
If you would like to discuss bedwetting and the possible treatment options, please contact me at Aucupuncture Studio at Pt Chevalier, Auckland city.