What is the cause of coughing and enuresis?

Excluding the cause of bladder sphincter relaxation, coughing and enuresis may be caused by stress urinary incontinence. Stress urinary incontinence means that urine flows out of the urethra when abdominal pressure increases. The bladder needs to be emptied every time you urinate, and appropriate pelvic floor muscle strength training should be performed. There are many reasons for coughing and enuresis, which need to be analyzed from both Chinese and Western medicine perspectives. This article introduces the causes of enuresis due to cough.

1. Delayed development of the neuroendocrine system in the brain

(1) Detrusor instability or low-compliance bladder (high sensitivity to urine storage), reduced functional capacity of the bladder, and the actual amount of urine that can be stored is smaller than normal. Patients often experience frequent urination, urgency, and even urinary incontinence during the day or before bedtime.

(2) The bladder's filling and contraction sensing function is incomplete, and bladder filling and contraction fail to wake the patient from sleep.

(3) Insufficient urethral closure function, that is, unstable urethra. It also manifests as frequent urination, urgency, and urinary incontinence.

(4) Insufficient secretion of antidiuretic hormone (ADH) from the pituitary gland leads to increased urine production at night, which exceeds the capacity of the bladder.

1. Sleep Factors

In the early days, it was generally believed that enuresis was caused by deep sleep and a high awakening threshold. In fact, enuresis has nothing to do with the depth of sleep, and enuresis does not occur during deep sleep.

A large number of nocturnal continuous EEG studies have shown that:

(1) Arousal dysfunction is an important cause of enuresis. Impaired perception of bladder filling and contraction and excessive fatigue leading to deep sleep can lead to arousal disorders.

(2) Poor urinary control function is more significant after falling asleep, indicating that delayed development of urinary control function plays an important role in the occurrence of enuresis.

(3) The sleep cycle of patients with enuresis is disrupted, and this is more obvious in patients who are often woken up at night to urinate.

1. Mental, psychological and behavioral disorders

Enuresis can lead to mental, psychological and behavioral abnormalities in patients, which in turn may become one of the causes of persistent and intractable enuresis in patients, especially older children and adults.

The common psychology of this type of patients is that they are afraid of enuresis and hope to prevent it by urinating frequently. Affected by this psychological factor, patients still remind themselves to urinate during sleep. The detrusor center in the frontal lobe of the brain is therefore in a highly excited state, which increases the sensitivity and contractility of the bladder. A smaller bladder capacity can produce the urge to urinate. If the brain produces a dream scene that allows urination conditions, the detrusor muscle will receive a vague reinforcement of the urination consciousness, while the urethral sphincter will relax and enuresis will occur, which in turn causes a decrease in the functional capacity of the bladder.

In addition, the secretion of ADH and psychological changes are both controlled by the hypothalamus of the brain, so the two are closely related.

1. other:

Urinary system diseases such as phimosis, prepuce is too long, urethral stenosis; gastrointestinal diseases such as long-term constipation or diarrhea, anal fissure, irritable bowel syndrome; pituitary or nephrogenic diabetes insipidus; diabetes; allergic reactions to food; intestinal parasitic diseases such as pinworms and ascariasis; physical diseases of the heart, liver, kidney, lungs, etc. can all be causes of enuresis. The above reasons account for about 10% of enuresis patients.

1. Traditional Chinese Medicine Theory

The causes of bedwetting are multifaceted. It is caused by the loss of control of one or several organs, which ultimately leads to kidney deficiency and bladder dysfunction. There are generally two aspects: deficiency, mainly due to weak kidney qi, coldness of the lower abdomen, deficiency of the spleen and lungs, and bladder dysfunction; excess, mainly due to damp heat in the liver meridian, heat forcing the bladder and failure of restraint.

1. Enuresis in childhood has not been treated or has not been treated correctly until now.

2. Due to the accelerated pace of life in modern society, the pressure of work and study has increased significantly, causing excessive mental or physical labor, resulting in physical and mental fatigue, deep sleep or sleep disorders, and decreased overall resistance of patients.

3. Suffering from congenital spina bifida, lumbar spinal cord dysplasia, cerebral hypoplasia, or acquired neurological diseases such as trauma or strain of the nervous system.

4. Sudden fright, sudden change to a new environment, family accidents, etc. can cause mental trauma.

5. Urinary tract infection, urinary tract obstructive diseases (congenital urethral malformations, acquired prostatic hypertrophy, etc.), urethral sphincter relaxation in postpartum women or middle-aged and elderly women, etc.

6. Diabetes, diabetes insipidus, chronic liver and kidney diseases, etc.

7. Chronic constipation or chronic diarrhea, gastrointestinal diseases such as irritable bowel syndrome, intestinal parasitic diseases such as pinworms.