How to Treat Urinary Reflux in Children
Observe and carefully monitor your child’s health., Be aware of the chances that each grade of reflux has of resolving without surgery., Determine if dysfunctional voiding is a part of the problem., Treat the dysfunctional voiding to combat the...
Step-by-Step Guide
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Step 1: Observe and carefully monitor your child’s health.
Lower grades of reflux resolve without surgery in most children.
This usually occurs as the bladder and its ureteral valve undergo growth.
If children with lower grades remain free of recurring infections, new kidney injury is uncommon. -
Step 2: Be aware of the chances that each grade of reflux has of resolving without surgery.
The chance of the reflux resolving depends somewhat on how old your child is when he or she is diagnosed.
The longer the child has had reflux, the less likely that it will resolve on its own.
The intensity of the reflux is described as a ‘grade’, with grade 1 being the least intense, and most likely to resolve without surgery The overall likelihood of the reflux eventually resolving without surgery is roughly:
Grade 1: 80 to 90%.
Grade 2: 70 to 80%.
Grade 3: 50 to 60%.
Grade 4: 10 to 20%.
Grade 5: 5 to 10%. , Voiding dysfunction refers to several common conditions in which children have abnormal urination patterns with and without moderate to severe constipation.
Some common signs that your child is dealing with dysfunctional voiding include:
Frequent urination with urgent running to the bathroom or daytime wetting.
Urination may be infrequent, perhaps two to three times a day or less.
Keep in mind that parents may be unaware of constipation if their child does not recognize or admit to it. , Treatment of voiding dysfunction usually requires some combination of bladder retraining, behavior modification, medications, and pelvic floor biofeedback therapy.
Most large pediatric medical institutions have specialists or programs that can assist in developing a treatment program specifically for your child.
You can also read about treatments for voiding dysfunction here. , Children, mostly girls, with dysfunctional voiding are prone to recurrent UTIs.
In general, after age one, girls have UTIs more frequently than boys.The risk of a girl getting a UTI, in general, can be diminished by good hygiene in the genital area (keeping clean and dry, wiping front to back, and wearing cotton underwear all help), and drinking enough water to void a dilute urine 5 to 7 times a day.
Common symptoms of UTIs include:
A burning sensation when urinating.
Unusual-smelling urine.
Fever.
Nausea, vomiting, and diarrhea. , When a UTI is suspected, an antibiotic with broad effectiveness against most of the usual bacteria is selected until the urine culture result is available (urine cultures will be discussed in the next step).
The usually takes 24 to 48 hours.
Most uncomplicated UTIs in children are treated for about 7 days.
For more serious infections, treatment should be for 10 to 14 days or more.
Common antibiotics include:
Amoxicillin, Trimethoprim, sulfamethoxazole, and Nitrofurantoin. , Take your child to a doctor to have a culture taken to see if the child has bad bacteria, which can cause the infection, in his or her urinary tract.
The culture may take a few days to a week to be processed.
If the culture is negative, any antibiotic treatment can be discontinued.
If the culture is positive, the choice of antibiotic may be changed to select the one with the most specific effectiveness.
Your provider will receive this information with the urine culture result. , Children with frequent UTIs, especially those with reflux, can receive long-term (months to years) treatment with “low dose” antibiotics; this is called antibiotic prophylaxis.
The rationale is that daily small doses of antibiotics will “suppress” bacterial growth in the urine and prevent the UTI from developing. , During observation or medical management, periodic kidney and bladder sonograms can document normal kidney growth and can make sure that no new kidney scars have formed.
If the sonogram is not sufficient or inconclusive, a kidney scan test called a DMSA renal scan has a very high sensitivity for kidney scars. -
Step 3: Determine if dysfunctional voiding is a part of the problem.
-
Step 4: Treat the dysfunctional voiding to combat the reflux.
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Step 5: Understand that urinary tract infections (UTIs) are also a condition that can lead to reflux.
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Step 6: Treat your child’s UTI with antibiotics.
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Step 7: Have a culture taken to determine if your child really has a UTI.
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Step 8: Talk to your doctor about continuous antibiotics to treat recurrent UTIs.
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Step 9: Schedule regular sonogram appointments for your child.
Detailed Guide
Lower grades of reflux resolve without surgery in most children.
This usually occurs as the bladder and its ureteral valve undergo growth.
If children with lower grades remain free of recurring infections, new kidney injury is uncommon.
The chance of the reflux resolving depends somewhat on how old your child is when he or she is diagnosed.
The longer the child has had reflux, the less likely that it will resolve on its own.
The intensity of the reflux is described as a ‘grade’, with grade 1 being the least intense, and most likely to resolve without surgery The overall likelihood of the reflux eventually resolving without surgery is roughly:
Grade 1: 80 to 90%.
Grade 2: 70 to 80%.
Grade 3: 50 to 60%.
Grade 4: 10 to 20%.
Grade 5: 5 to 10%. , Voiding dysfunction refers to several common conditions in which children have abnormal urination patterns with and without moderate to severe constipation.
Some common signs that your child is dealing with dysfunctional voiding include:
Frequent urination with urgent running to the bathroom or daytime wetting.
Urination may be infrequent, perhaps two to three times a day or less.
Keep in mind that parents may be unaware of constipation if their child does not recognize or admit to it. , Treatment of voiding dysfunction usually requires some combination of bladder retraining, behavior modification, medications, and pelvic floor biofeedback therapy.
Most large pediatric medical institutions have specialists or programs that can assist in developing a treatment program specifically for your child.
You can also read about treatments for voiding dysfunction here. , Children, mostly girls, with dysfunctional voiding are prone to recurrent UTIs.
In general, after age one, girls have UTIs more frequently than boys.The risk of a girl getting a UTI, in general, can be diminished by good hygiene in the genital area (keeping clean and dry, wiping front to back, and wearing cotton underwear all help), and drinking enough water to void a dilute urine 5 to 7 times a day.
Common symptoms of UTIs include:
A burning sensation when urinating.
Unusual-smelling urine.
Fever.
Nausea, vomiting, and diarrhea. , When a UTI is suspected, an antibiotic with broad effectiveness against most of the usual bacteria is selected until the urine culture result is available (urine cultures will be discussed in the next step).
The usually takes 24 to 48 hours.
Most uncomplicated UTIs in children are treated for about 7 days.
For more serious infections, treatment should be for 10 to 14 days or more.
Common antibiotics include:
Amoxicillin, Trimethoprim, sulfamethoxazole, and Nitrofurantoin. , Take your child to a doctor to have a culture taken to see if the child has bad bacteria, which can cause the infection, in his or her urinary tract.
The culture may take a few days to a week to be processed.
If the culture is negative, any antibiotic treatment can be discontinued.
If the culture is positive, the choice of antibiotic may be changed to select the one with the most specific effectiveness.
Your provider will receive this information with the urine culture result. , Children with frequent UTIs, especially those with reflux, can receive long-term (months to years) treatment with “low dose” antibiotics; this is called antibiotic prophylaxis.
The rationale is that daily small doses of antibiotics will “suppress” bacterial growth in the urine and prevent the UTI from developing. , During observation or medical management, periodic kidney and bladder sonograms can document normal kidney growth and can make sure that no new kidney scars have formed.
If the sonogram is not sufficient or inconclusive, a kidney scan test called a DMSA renal scan has a very high sensitivity for kidney scars.
About the Author
Sara Ruiz
Specializes in breaking down complex hobbies topics into simple steps.
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