Frequent Urination in Children: "Why Do Kids Keep Going to the Bathroom?"

Hello. Today, I'd like to talk about a somewhat peculiar issue often seen in children. It's the problem of "My child goes to the bathroom too often." In fact, this is a much more common concern than you might think.

Parents often start by saying things like: "They go to the bathroom twenty, thirty times a day." "Only a little urine comes out, but they constantly feel the urge to go." "I'm worried it might be a serious illness."

When children suddenly act like that, anyone would be concerned. Thoughts like 'Could it be a kidney problem?', 'Is it diabetes?', or 'Could it be a urinary tract infection?' naturally come to mind.

That's why basic tests are absolutely necessary: urinalysis, urine culture, and sometimes even a blood glucose test. But the problem is, there are cases where the test results are all normal, yet the child's "frequent bathroom visits" don't stop. In such cases, we specifically consider two possibilities. One is psychogenic pollakiuria. The other is urinary tics.

1. Psychogenic Pollakiuria – How Children's Minds Send Signals

Psychogenic pollakiuria, a condition often referred to simply as pollakiuria, literally describes the phenomenon where children frequently urinate only during the day, without any specific underlying medical condition.

Here are its characteristics:

• They go to the bathroom very frequently during the day, sometimes every 5 to 10 minutes.
• Only a small amount of urine is passed each time.
• However, they sleep soundly and without issue at night.

What's important to understand in such cases is that this frequent urination itself isn't a sign of a physical abnormality in the child, but rather the body's way of sending a signal in response to psychological tension or stress. Children often express emotions or tension through their bodies. This is especially true for children at an age where it's difficult to articulate complex emotions verbally.

2. But Could This Be a Urinary Tic?

There's one thing that can be confusing here. It's the bathroom-going behavior that can stem from tic disorders. As you know, tic disorders are neurological conditions characterized by involuntary, repetitive movements or sounds.

Urinary tics present a bit differently from psychogenic pollakiuria. Children with urinary tics try to go to the bathroom regardless of whether they feel the urge to urinate. Even without a real need to urinate, they try to go out of habit. They might try to go again immediately after returning, and sometimes hardly any urine comes out.

3. How Do We Differentiate Them?

When distinguishing between them, we need to look at a few key points.

• Does the child actually urinate when they go to the bathroom?
  • With psychogenic pollakiuria, a small amount of urine is passed each time.
  • With urinary tics, sometimes they just go and come back without urinating.
• What about at night?
  • Psychogenic pollakiuria usually poses no problem at night.
  • Tics also decrease at night, but in severe cases, they can even appear in dreams.
• Are there other tics besides urinary tics (e.g., eye blinking, facial grimacing)?
  • If so, a tic disorder can be more strongly suspected.
• How do symptoms change when their attention is diverted?
  • With psychogenic pollakiuria, symptoms often decrease when the child is engrossed in play.
  • Tics can involuntarily emerge even when the child is engrossed in something.

4. How Should We Approach Treatment?

First and foremost, the most important thing is to reassure the child that "This is not a serious illness." Repeatedly telling your child, "Your body is working just fine," "Sometimes this can happen when you're stressed," and "It will get better with time," is crucial.

If it's psychogenic pollakiuria:

• Practice scheduled bathroom visits (e.g., every 2-3 hours)
• Maintain normal fluid intake
• Create a play environment where they can be engrossed in activities
• Avoid scolding them even if they go very frequently; treat it naturally

If it's a urinary tic, a slightly different approach is needed. Excessive attention or intervention regarding tics can actually worsen them. Help the child learn ways to reduce tension themselves (e.g., deep breathing, relaxation exercises), and if necessary, additional evaluations can be sought.

However, what's important in both cases is not to be impatient. In most cases, symptoms gradually improve over time as the child's stress eases and their emotional regulation skills develop.

It's natural to worry when your child keeps going to the bathroom. However, if there's no physical abnormality, it could be a signal from your child saying, "I'm a little anxious," or "I've become a bit sensitive." Rather than forcibly trying to stop these signals, calmly accept them, gently adjust the surrounding environment if necessary, and help your child find a sense of stability themselves. That is the best approach.

#PediatricFrequentUrination #PsychogenicPollakiuria #UrinaryTics #IncheonPediatricFrequentUrination