A child sitting on a toilet.
Overactive bladder in kids may be caused by anxiety or a change in routine.

Overactive Bladder in Kids

Overactive bladder (OAB) is fairly common in children, though it is often confused with enuresis; enuresis is frequent bedwetting. In this article we explore the symptoms, causes and treatment options for overactive bladder in kids. We also cover how to tell the difference between OAB and bedwetting.

What Is Overactive Bladder?

OAB is a sudden, uncontrollable urge to empty the bladder. This leads to accidents throughout the day, which is embarrassing to children because they are gaining independence. As such, it can impact day-to-day routines and disrupt social and emotional development.

Overactive bladder in kids is difficult to diagnose. After all, accidents are common up until about the age of 3. There are also variances depending on social and emotional development. As such, OAB may not be diagnosed until much later in childhood.

What Are the Symptoms of Overactive Bladder in Kids?

The most common symptoms associated with OAB in children:

  • A sudden, uncontrollable need to urinate
  • Having the urge to urinate without actually being able to urinate
  • Frequent daytime wetting after the age of 3
  • Frequent nighttime wetting after the age of 4
  • Rushing to the bathroom
  • Interrupted sleep
  • Frequent urinary tract infections

Unfortunately, having OAB often impacts social and emotional development. Because the child may be trying hard to control the urge to urinate, and failing, physical complications may also develop:

  • An increased risk for urinary tract infections
  • An increased risk for kidney damage
  • Difficulty emptying the bladder completely

What Are the Causes of Overactive Bladder?

There are various causes of OAB. For children ages 4 to 5 they may be:

  • A disruption in routine, such as a move to a new city or home or a new sibling joining the family
  • Illness
  • Forgetting to use the toilet because they are enjoying other activities
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Common causes for children of all ages:

  • Anxiety may trigger bedwetting
  • Consuming carbonated or caffeinated beverages; both irritate the bladder, causing more frequent urination and may even cause bladder spasms
  • Being upset
  • Constipation, especially if constipation is chronic
  • Having frequent urinary tract infections
  • Having underlying sleep apnea
  • Being “too busy” to completely empty the bladder when using the toilet
  • Having nerve damage or an underlying medical condition that causes the child to be unable to detect when the bladder is full
  • Consuming something that the child is allergic to may cause OAB symptoms

How Is It Diagnosed?

Often, OAB is observed by the healthcare provider until about the age of 7. Generally, OAB is outgrown by this time.

When the child reaches 7, if OAB symptoms are still present, a series of tests will likely be ordered. These tests are ordered to rule out other medical conditions that may be causing symptoms. Examples include urine tests to check for infection and ultrasounds to review the bladder and connecting systems for any abnormality. In the absence of abnormalities, the healthcare provider may arrive at a diagnosis of OAB.

How Is It Treated?

The most common treatments are noninvasive and nonmedicinal: bladder retraining and pelvic floor exercises.

Bladder retraining involves recommending that the child empty the bladder on a schedule. Urinating on a set schedule allows the bladder to slowly expand the volume that it is able to hold. Pelvic floor exercises strengthen the muscles that are used to “stop and go” (this prevents wetting). If these options have failed, medications may be prescribed.

OAB Medications

The most commonly prescribed OAB medications:

  • Antibiotics. When OAB symptoms are related to urinary tract infections, antibiotics treat the source of infection.
  • Laxatives. When OAB symptoms are related to constipation, laxatives assist with relieving constipation.
  • Oxybutynin. This medication relaxes the bladder, thus reducing the urge to urinate as frequently. It does have side effects, such as a dry mouth and constipation, so it is only used if other options have failed.

At-Home Remedies

There are other at-home remedies that may reduce symptoms of OAB. These remedies involve adjusting lifestyle habits. For example, if your child consumes an excess amount of caffeinated or carbonated beverages, it is wise to cut these beverages out of their diet.

It is important to consume an adequate amount of liquids but try not to allow your child to drink most of their liquids before bed. This is only recommended if your child suffers from nighttime wetting.

There are certain foods that may improve bladder health. These foods include pumpkin seeds, cranberry juice and water. Serve your child these foods and beverages if they are willing.

Above all else, reward positive behavior while trying not to punish your child for wetting accidents.