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“Enuresis” is a term of Greek origin that literally means “to expel urine.” In traditional Chinese medicine or TCM, this disease is usually referred to as yi niao. The literal translation of this into English is “loss of urine.” In North America, enuresis is what we commonly refer to as bed-wetting. The modern Western medical term for bed-wetting is nocturnal enuresis. This is described as the involuntary voiding of urine during sleep beyond the age of anticipated urinary control. This condition most commonly occurs during childhood. Therefore, pediatric enuresis is the primary focus of this book. Nevertheless, the basic pattern discrimination and treatment of enuresis is the same in adults or the elderly as it is in children. The only difference is that certain Chinese medical patterns of enuresis tend to be more prominent at certain ages. There are two types of enuresis in modern Western medicine: primary and secondary. In TCM, this distinction is not truly necessary during diagnosis and treatment as long as the correct pattern has been identified. In modern TCM journals, the number of cases of each of the two respective types of enuresis is usually identified in the cohort description. However, the treatment is not changed based on these subtypes.
Primary nocturnal enuresis (PNE)
By far, primary nocturnal enuresis (PNE) is the most commonly occurring form of enuresis. It is distinguished as the type of enuresis found in individuals who can control their bladders during the day (for at least 6-12 months) but who have not been continuously dry at night for at least a six month period since infancy. In this type of enuresis, bed-wetting has to be present at least two times per month to make the diagnosis in children 3-6 years of age and at least one time per month in older individuals.
bed-wetting affects many millions of people around the world.S. 7. Israel. thus do not wake as easily. When is wetting the bed not considered normal? In modern Western medicine.. The most notable difference between the two types of enuresis. In TCM journal articles not utilizing these modern Western medical criteria. it is over the age of six. there are . The prevalence of SNE as a percentage of all cases of nocturnal enuresis increases with age. Therefore. while in males. In a study of New Zealand children. alone experience nocturnal enuresis. According to studies in the U. is that SNE (unlike PNE) is often caused by psychological factors. in my home country of Canada (which has a much smaller population). UK.4 Treating Pediatric Bed-wetting with Acupuncture & Chinese Medicine Secondary nocturnal enuresis (SNE) Secondary nocturnal enuresis (SNE) refers to a relapse after control has been achieved for a period of at least six months. 10% of six year-olds suffer this disease. According to my professor in China who specialized in the treatment of pediatric enuresis. enuresis may be diagnosed in females over five years of age. This aspect will be examined in further detail below under the causes of enuresis according to modern Western medicine.S. Twentyfive percent of bed-wetting cases are diagnosed as SNE. In any case. and Africa. (1) For instance. This professor further explained that (at least in his opinion) children wearing diapers do not feel the wetness. corresponding statistics on enuresis from the Canadian Kidney Foundation show that this condition is present in: 20% of five year-olds (1 in 5) 10% of six year-olds (1 in 10) 3% of 12 year-olds (1 in 33) 1% of 15 year-olds and older It is estimated that between 5-7 million children in the U. these children’s ability to control their night-time urine is delayed. bed-wetting is often diagnosed as early as three years of age. this difference in age criteria between modern Western medicine and TCM is due to the fact that babies in developed countries wear diapers (whereas in China this is fairly uncommon).9% of them developed SNE before they were 10 years of age. Furthermore.
research suggests that there is a higher incidence of this disease in poorly educated.and night-time control of urine at varying ages. lower socioeconomic groups and in institutionalized children. Table 1 demonstrates the percentage of children in the United States who achieve day. with most children achieving night-time dryness by the age of four or five. Eighty percent of children with enuresis wet the bed only at night. this commonness does not diminish the need for patients and their families to take action and seek treatment for it.Introduction 5 approximately 200. This means that the majority of children with enuresis will eventually stop by themselves. this occurs at a later age. Nevertheless.0 2. 78% of children do not wet their bed at this age. one can find other studies on the same topic which present a substantially larger number of females suffering from this condition. bed-wetting at night is normal and expected. AGE (YEARS) 2. I agree strongly with the current medical consensus that the worst thing one can do about . this finding has been disputed by other reports.0 TABLE 1. while approximately 20% also experience daytime incontinence.5 3.000 children who suffer from this childhood disease. According to the table below. there is a spontaneous remission rate of 15% per year after the age of five years old in those who suffer from bedwetting. Table 1 below provides some statistical support for the Chinese diagnosis of enuresis at three years of age. (2) A review of hundreds of journal articles from the past 25 years on the TCM treatment of enuresis demonstrates that there is usually a slightly higher incidence of enuresis in males. The ability to control urination and remain dry at night directly correlates with the achievement of continence throughout the day. During the first 2-3 years of life. although this condition is a common one. However. However. Various studies report that boys wet the bed more frequently than do girls. PERCENTAGE VARIOUS AGES OF DRY BY DAY 25% 85% 98% CHILDREN DRY BY DRY BY NIGHT 10% 48% 78% DAY AND NIGHT AT Further. for some. (3) In addition. However.
“The Psychological & Social Effects of Enuresis” for more information on this aspect of this condition.6 Treating Pediatric Bed-wetting with Acupuncture & Chinese Medicine a child’s enuresis is nothing. once an individual reaches puberty. As stated above. this condition is significantly more difficult to treat. They have already tried some method of treatment that did not work and have become discouraged. once the individual stops growing. The Chinese medical treatment of this disease is very successful as indicated by the research in this book. the odds of their case spontaneously resolving without treatment becomes minute. Chinese medicine offers a variety of treatments that are effective in treating enuresis. soiled sheets and clothes. The parents feel ashamed of the situation and feel that somehow this condition reflects poorly either on them as parents or their children (which you will discover below is entirely incorrect). most of all. 2. and. Several reasons have been identified for this fact: 1. 3. if it is the child’s birthday and he or she is between five years old and the end of puberty. This is one of the primary purposes of this book—to educate practitioners of TCM and the parents of these bed-wetting sufferers that Chinese medicine is a valuable and effective option. their enuresis will be gone unless appropriate treatment is given. it is important to remember that. very discouraged children and their parents. . There is no need for these children to suffer. They simply hope that time will resolve the situation. Unresolved bed-wetting means another year of interrupted sleep (for the child and their family). When compared to modern Western medicine. Rarely outside of China have families sought out treatment from a practitioner of TCM to treat their child’s enuresis.) Even worse. They are not aware that there are excellent treatment options available. Even doctors in China agree that. 4. Unfortunately. (See Chapter 2. there is only a 15% chance that. However. these treatments are superior and have better rates of resolution with no side effects. by the time they celebrate their next birthday. it is estimated that only 38% of parents seek medical assistance for their child’s bed-wetting.
this is also true. and. Included in this book are over 200 Chinese medical treatments that have been proven to be effective in treating enuresis. with the right treatment.Introduction 7 Children who have enuresis deserve relief from their suffering. in the case of enuresis. almost everyone can improve their condition within a matter of weeks. From a TCM perspective. a variety of effective solutions are available and may be used alone or in combination with other methods. and. . It is a clinical reality that different treatments work better for different people.
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