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The first signs of constipation appear already at the first episode of the stool delay in a newborn more than 36 hours. After this time, the chair may be, but at the same time the child is crying and is strongly satisfied to be a defecation. This is considered one of the symptoms of constipation, even if the defecation frequency is normal. The consistency of the chair in the form of a decorated or solid feet is also considered a symptom of constipation, if it is not cascidious. Therefore, the newborn symptoms of constipation is not only a change in the frequency of defecation, but also the consistency of the chair and the very intestinal proception process.

If the baby does not cook for a long time, then the stool delay enhances the fermentation processes in the intestine and enhances gas formation. Therefore, bloating, gases and constipation in newborns are often joint symptoms. The child begins to capricious, cry and breaks the feeding process. The child, though he wants to eat, but bloating in the stomach does not give him to eat the volume he wants. Thus, the child is hungry and even more capricious. He swells the tummy due to the increased amount of gazikov, which cannot move away against the background of increasing the carts. This may be accompanied by colic in the stomach. Symptoms then become more expressive - the child is crying, nothing can calm him, except for a long time swing for a long time or a defecation process.

Constipation in a newborn with breastfeeding may be if the mother ate something from products that make it difficult to peristaltics of the intestine. Therefore, if such constipation in the child is the first time, then the mother can trace his diet and include products with a prokinetic effect. This will allow the symptoms of the Baby constipation to pass over the background of the mum diet correction. Constipation in a newborn during artificial and mixed feeding can appear already when the mixture is first introduced - then this may indicate an incorrectly selected mixture.

Hungry constipation in a newborn can be with late and improper power mode. Sometimes mom may not be aware of the frequency with which you need to feed the baby - and this is an arbitrary mode at the request of the kid himself, which should be no less than eight times a day or not less than every three hours. When feedings are not enough, the child will cry and it will have constipation for the reason that there is no sufficient food in the intestine so that it stimulates the peristaltics. Then the symptoms of hypotrophy will appear - that is, the child will stop typing enough in weight, it will be capricious and sluggish. In this case, it is necessary to turn to the doctor to evaluate the feeding mode and weigh the child.

Speaking of congenital intestinal obstruction, the symptoms appear from the first days of life. The child does not leave the Mekonia or delayed his teaching. In case of inspection, the asymmetry of the tummy is noted, it can be offered on the one hand, and on the other time there may be spasmodic phenomena. There may be vomiting and intoxication of the body. It is delayed not only feces, but also the extension of gases. These symptoms are dangerous and require immediate action.

Congenital hypothyroidism is manifested in the first month of life, but only a doctor can notice such symptoms. Symptoms that may see mom are limited only by constipation. This is due to the lack of hormones of the thyroid gland, which in the body of the child play an important role, since they provide differentiation of all organism cells. They stimulate the intestinal peristalsis, provide energy processes, take part in the division of nerve cells. Therefore, with hypothyroidism, in addition to constipation, symptoms of development delays and reducing the energy potential of the children's body appear. When examining such a child, it can be noted that it is more by weight than it should be, he is calm and mom does not cause anxiety. He has a big springkin and sometimes side can not be closed on the background of the transfer of the fetus. Such a baby has a weak voice, he is sluggish and slightly lagging behind in development. But only a doctor can notice such features in such a small age, and a mom can disturb only constipation.

In the period of the newborn, the child must eat, sleep and cool well - this is the key to its excellent condition. If a child has constipation, then a cry is already appearing, bloating a tummy, anxiety and sleep disorders. All this must be taken into account when diagnosing constipation of children.

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Constipation - Is the child sick? The newborn is often cocked after each feeding, but there are kids whose diapers can remain clean for 3-5 days. Does this mean that a newborn constipation? Alla Anatolyevna Shcherbakova, k. M., Doctor of the highest category, a pediatrician who takes young patients, working as Deputy Head of DC "Mother and Child" on Savelovskaya, helped to understand the features of the digestion of newborns and possible causes of a rare chair, and also told How to safely help the intestinal emptying is still a very small child.

The World Health Organization defines constipation as systematically difficult and insufficient defecation.

- Alla Anatolyevna, many mothers worry that their child has no stool for several days, - what is the norm and how to understand that the newborn constipation?

- In the period of the newborn and in the first months of life, the chair can follow as each feeding, and once every three days. Lack of emptying for more than three days is considered to be constipated, less - stool delay. A full-fledged defecation, comparable to the amount of nutrition and cases when the child pokes at all in a little bit, - both options are taken for the rate and treatment do not require.

The newborn constipation, if there were no defecation within 3 or more days.

- What are the reasons for children experiencing difficulties with the intestinal cleansing? Why does the newborn have constipation?

- Constipation in a newborn is a fairly frequent complaint at a pediatrician and a children's gastroenterologist. The baby does not cake independently and does not have a chair for several reasons.

  1. The newborn baby is most of the time in a horizontal position, and the intestinal emptying is different (in adult defecation begins under the physical effect and the effects of acids that are distinguished during the digestion).
  2. The immaturity of the anterior abdominal wall, the immaturity of the enzymatic system, the incomparated reflexion defecation also lead to the absence of an independent stool.
  3. Congenital factors can influence the situation, but it is possible to talk about them when the child becomes older, it starts to move more and getting food fibers from plant food during the dust.

Reasons for bumps

Some children are sensitive to power change. Rare feces can be the result of introducing a doctoctor, replacement of the mixture, started dust, transition from vegetables to porridge. This is normal for kids.

- The constipation in the newborn is more often noted with breast or with artificial feeding?

- Research data about the frequency of the chair under different types of feeding is not. But, in my practical experience, the child-artificial does not have an independent chair more often than infant. Between the mother and constipation of the baby on natural feeding, the connection is not traced. And if the constipation arises from a woman (this is a frequent complaint after childbirth), it can be advised to include more vegetable fiber, fresh vegetables and fruits, dried fruits into the diet.

Boys and girls suffer from constipation when nutrition like a children's mixture and breast milk.

- How to distinguish constipation from other problems with digestion?

- Difficulties with a detergent - not such a big problem, as diarrhea in the infants, which is most often treated. Infant constipation is often physiological and does not require therapy, as caused by the anatomical features of the newborn, which change. If pathology is not observed, then the child, even in the absence of an independent chair, it usually feels well, has an excellent appetite, it is sufficiently added weight.

- When do pediatricians begin to talk about constipation as a serious problem?

- If the child is emptied by the intestine once every three days, this is the norm. But if the constipation leads to changes in well-being - the baby does not sleep, does not eat, mans legs, colic is tormented, - in this case, it is necessary to help. You need to contact the pediatrician when parents do not cope with the problem themselves. Most often, an independent chair at the kid can be established at home, but it happens that the parents give the nerves and they begin to invent diseases.

- How to help newborn during constipation?

- The task of parents is to achieve an independent chair once every three days. The main recommendation for newborns is a microclism or a laxative candle that will help to form a reflex defecation. The kid who has not formed this reflex simply does not know how to empty the intestines. The use of mechanical means, as a rule, leads to emptying and relief of its condition, as well as to the improvement of the microclimate in the family, because the child ceases to experience discomfort.

How to facilitate the condition of the child during constipation

- How long does the baby adapt to artificial nutrition and is it possible to change the mixture from which constipation appeared?

- Artificial nutrition is not the treatment of constipation, and for its prevention, mixtures of the category "Comfort" are prescribed. Serious states when a child cannot empty independently and has a defecation only after microclizm or candles, is a reason for the appointment of medication therapy.

After breastfeeding, they began to give a mixture, but the child had constipation - wait 3-5 days until the adaptation of the body to a new dairy squirrel was completed.

- Alla Anatolyevna, the initial choice of the mixture or its replacement - always the prerogative of a specialist?

- Better when the mixture picks up a children's doctor. Without complaints about health, any mixture of age, intended for feeding healthy babies can be selected.

With complaints on a rare chair, anxiety when feeding, jeeping, abdominal pain The newborn definitely needs to contact the doctors. Taking into account all factors, the doctor will choose the mixture that is aimed at the specific problem of a particular child.

For example,

In the treatment of food allergies:

  • need mixtures with full protein hydrolysis

In the family burdened allergic:

  • partial hydrolyzates mixtures are prescribed,
  • Mixtures on goat milk

The doctor will look at the child's reaction, prescribes a test inspection 7-14 days after the introduction of the mixture and then will decide, it is suitable or not, and if necessary, it will continue to pick up food.

What to do if a child has constipated

The newborn constipation: what to do to form a deflexion reflex

Massage tummy when constipation in a newborn

  • Massage is prescribed from three months when the newborn reflexes (flexing tone) and kid spreads out.
  • Massage is aimed at strengthening the front abdominal wall, turning.

Medicine during the rest of the newborn

  • Medicinal preparations appoint a doctor.
  • Course treatment is short.
  • After establishing digestion, the drug is canceled.

Diet baby during constipation

  • The first months are the dairy formula with the "Comfort" marking or a mixture of goat milk.
  • The second half of the year is a diet with an elevated content of plant fiber (folk remedies during constipation), which includes fresh vegetables, fruits, dried fruits, greens, vegetable oil; Restriction of refined carbohydrates.

Enema when constilling in infants

  • Microclizms, a gas-conductive tube, lightweight candles, cotton wand - are assigned and used only with the permission of the doctor.
  • The means have one effect - irritation of the anal sphincter, which causes a defecation.

It is categorically impossible to fight constipation yourself

  • If the baby has a temperature, he is sick and does not cocket - the price may be associated with surgical pathology or other illness.
  • You should not do the enema if the child has a stomach hurts, the skin is changed around the anal hole, there are cracks, redness, scratches that cause pain.

Disorders of intestinal emptying in small children - a frequent complaint. Popps, as a rule, do not change the state of the newborn: he has a good health and a normal weight set. If you cannot cope with the problem independently, you need to consult a doctor to get a treatment or calm down, learning that the baby is all right and do not need to do anything.

Pediatrician Alla Anatolyevna Shcherbakova

* The perfect food for the breast is Mother's Milk. WHO recommends solely breastfeeding in the first 6 months. Mamako. ®Supports this recommendation. Before the introduction of new products to the diet of new products, consult with a specialist.

The constipation is a slow, difficult or systematically insufficient emptying of the intestine. And the constipation in children is a problem with which parents are often faced. Is it worth worrying if the baby rarely goes to the pot, in what cases it is important to turn to the doctor, and in which the problem independently can solve, tells the famous children's doctor, a candidate of medical sciences, TV host Evgeny Komarovsky.

Evgeny Komarovsky

Known Children's Doctor, Candidate of Medical Sciences, TV presenter

"Very often constipation is not an independent illness, but only a symptom - ulcerative disease, hemorrhoids, pancreatitis, cholecystitis, disorders of the thyroid gland"

- If we are talking about the children of the first year of life, in one case, several thousand constipation may be a consequence of the so-called Girshprung disease, - continues Evgeny Komarovsky. - This innate disease, at which nerve cells are not developed on one of the intestines in one of the intestines, the peristalistic and the cartilagings are disturbed in the intestine. The output in this case is one - the operation.

In short, permanent problems with a chair in a child should encourage parents to turn to a gastroenterologist who would exclude the diseases of the gastrointestinal tract.

Stool delays in infants - this is normal

Each baby has its own intestinal emptying frequency, which depends on many factors. And it is important to remember this:

- In childhood children, rare intestinal emptying almost always indicates that the food that the child eats, high-quality, is perfectly suitable for him and is almost completely absorbed, "says Evgeny Komarovsky. - And if the baby is powered by a maternal milk or an adapted mixture, if you enter the correct luch in time, but at the same time the baby does not cook to six days in a row - this is normal. Provided, of course, that this does not cause discomfort and does not affect health and development.

The better the food is absorbed, the less the baby goes to the pot

That is why most often the problem is not in the child, but in his surroundings.

"Grandmothers, having learned that the baby did not go to the pot for two days, they immediately begin to carry on this occasion, advise" to fly "by his folk methods, and the mothers are worried and look at the empty pot," says Evgeny Olegovich. - At the same time, the cause of the latency of the chair may be, for example, an excessive mother's concern. Judge for yourself. Say, mom has two potatoes. She can cook them in the uniform and give a child, while he will rise 80% of this dish, the rest will be released naturally. Either mom can cook them, clean, how to smoke, add milk and oils. It turns out a liquid puree, which will be learned almost entirely. There is just nothing to leave the body!

Five rules for the treatment of constipation

If the doctor is confident that the constipation is not a symptom of something serious, you can try to cope with it yourself. What should I pay attention to?

1. The child should not have a fluid deficit.

It is the lack of liquid - one of the most frequent reasons for constipation in children. Callery masses become dense, slowly moved by the intestines, scratch its walls, which causes pain and colic. Yes, and the urge goes to the toilet occurs only when the accumulated masses begin to put pressure on the walls of the rectum, the water helps to increase their volume, and the baby squeezes faster. So let me drink more and moisturize the nursery!

2. The body should have enough potassium.

With a shortage of potassium abbreviations (the so-called peristalistic) weaken sharply, and it may well be the cause of constipation. Most of all potassium in the raisons, Kurage, Cranemalve, figs, which, by the way, can be added to compote or there are simply paddy.

3. Fully diet rich in fiber.

With constipation, unwanted products rich in protein, such as chocolate, cottage cheese, nuts. The yoghurts, one-day kefir and prokobivash are desirable. Black bread is better than white. Apple juice is better than an entire apple. Meat is better limited. In general, fiber serves excellent constipation of constipation. This means that the child needs to give more fruits and vegetables, as well as the croup, better - slightly abnormal.

If the lactulosis and candles with glycerin do not help, go to the doctor

4. Safe medication.

There are only two drugs that can be used even in babies and at the same time without a doctor's prescription. The first is the syrup of lactulose, which is sold under different commercial names in any pharmacy. It increases the volume of carte masses, delays water in the intestine, does not cause "addiction", you can take it anyhow for a long time. True, at the first reception, the baby may form gaski - as a reaction to the drug, so the dose is better to increase gradually. The second is candles with glycerin. Their advantage is that glycerin is not absorbed by the body, but comes out with the bowel content, while there are such candles much softer than the enema.

If the cause of the constipation is cracked in the anus area (which appeared, for example, after passing the lumps of solid feces), because of which the child simply does not want to walk on a pot, fearing pain, "Candles with sea buckthorn oil will help.

5. Day mode.

It happens that the urge goes to go in large, the child feels, but ignores - for example, he is very busy or just does not want to go to the toilet in the garden or at school, preferring to be patient to the house. If such behavior becomes systematic, then the rectum begins to stretch from excessive masses, and in order to feel the urge to go to the toilet, the child needs more and more time. From here - constipation that have to be treated for a very long time.

To prevent this, it is important since childhood to teach the baby to the systematic emptying of the intestine. Better - at the same time and in the same usual setting. Let him go to the pot before bedtime or after breakfast, before leaving the house.

If all of the above does not help, you need to seek help to a doctor. It is important to understand that experts own a large set of diagnostic treatment schemes than parents.

Knock!

Constipation is a frequent side effect of taking iron preparations that are prescribed at low hemoglobin. Exit: Start taking iron at a dose, 2-4 times less than according to the instructions, and gradually increase it.

Evgeny Komarovsky talks about products that in 25% of cases help cope with constipation in a child without any medication. This is a glass of sources and 20 pieces of gasy prunes before bedtime for several days.

You can read more about constipation on the official website of Evgenia Komarovsky www.komarovskiy.net -> "Navigator" -> "Stop" (12+)

Publication date August 13, 2018. Updated December 4, 2020.

Definition of the disease. Causes of the disease

In increasingly, the reason for helping the children's gastroenterologist is becoming complaints about the delayed chairs in children.

Packs (coprostaz) - This is a violation of the intestinal cleansing function, in which the intervals between acts of defecation increase, the consistency of the chair changes, the systematically incomplete intestinal emptying arises.

Cluster of solid chair in the colon

In a healthy baby, the frequency of defecation can be diverse. It depends on the age of the baby, the quality of nutrition, the amount of water drilled and other moments. For example, the kids in the first months of life, which feed only with breast milk, the frequency of defecation ranges from 1 to 6-7 times a day. With the introduction of adhesive, the frequency of defecation is reduced, the chair becomes more dense. In case of artificial feeding the chair less often than in the breast. If you analyze older children, then the rate of frequency of their stool may vary from 3 times a day to 3 times a week.

It is concerned about the fact that parents often begin to beat the alarm - the child feels good, plays, eats, tolerates. [3] [four] And if small children are still under control, then adolescents can often be shy to talk about the violation of the chair. [2] Often it turns out at the reception of the gastroenterologist about another problem.

Causes of constipation:

  • Neurogenic etiology - manifestations of violations of the vegetative nervous system and vertebral innervation, psycho-emotional disorders.
Neurogenic etiology constipation
  • Suppression of natural urge to defecation. If a child is in an awkward place or position, he tries to restrain the urvet, "tolerates to the house." [8] [12] If this happens often, the sensitivity of the receptors is reduced, the gut is stretched and the state of constipation can progress.
  • Infectious diseases As a result of which a violation of ripening is possible or the death of the nerve ganglia of the digestive tract, which also leads to a decrease in the sensitivity of the intestinal walls.
  • Alimentary causes and low-quality food - The most frequent cause of constipation. An abundance of refined products, lack of fiber, violation of the regime and a hurry reception of food - all this can disrupt the process of digestion and evacuation of the edible lump. In addition, the long-term feeding of the kid with the rubber food, which inhibits the development of the chewing act, can lead to the development of constipation at an early age.
  • Endocrine pathology - Violation of the production of hormones of adrenal cortex, thyroid and parathyroid glands.
  • Using certain groups of medicines -Prants that reduce the towing intestine function: gangliplockers, cholinolics, tranquilizers and others.
  • Pathological states of the body - Diseases of the rectum and sphincter leading to painful defecation (fistula, hemorrhoids, cracks).
  • Socio-psychological reasons -New conditions, lack of familiar convenience for relaxation, antisanitary. In children, fear of defecation occurs with violent teaching to the pot. In the preschool and school age, unusual conditions can influence - the absence of individual cabins and the presence of foreign [nine] [12] .
Warning

When you find similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of constipation of a child

Frequency of defecation in children of different ages

The amount of breast detection depends on the type of feeding. On breastfeeding in the first months of life, the defecation occurs 2-3 times a day, on artificial - 1-2 times. After the six-month age - 1-2 times a day, after 4-5 years - once a day. Despite the variability of the frequency of the chair in young children, the lack of chair for more than a day should alert the parents. It should be borne in mind that the chair once every 2-3 days, if it is soft and painless, maybe a variant of the norm.

The constipation can be expressed as intestinal manifestations and generally clinic symptoms.

Local symptoms are manifested by a decrease in the frequency of the chair, the incomplete emptying of the intestine, compacted by the "fragmented" chair. [7] [8] [ten] These violations are often accompanied by pain in defecation and incontinence of feces. If children are the first months of life in the norm, casket masses, which, after the administration of the adhesive, turn from the cascum-shaped in the decorated, then when the chair is delayed, the chair is compacted before the "sheep" stool.

Bristol Cala Shape Scale

In the coprostase, spilled pain in the abdomen of different localization, passing after the intestinal emptying, bloating, anxiety and pain during defecation appear.

Generally clinical manifestations are characterized by fatigue, a decrease in appetite, headache, capriciousness (Caltal intoxication). At the skin can appear rash, gunnock, acne.

Acne, rashes during constipation

During the inspection, an increase in the volume of the abdomen is noted due to the accumulated gases, dense potassium masses in the sigmoid and rectum are detected during palpation.

The latency of the chair can accompany other pathologies of the gastrointestinal tract - gastroduodenites, cholecystitis, pancreatitis, functional disorders of the hepatobiliary system.

Based only on clinical data, it is not always possible to establish a mechanism of constipation: hyper- or hypotonic. However, hypotonic constipation differ in greater severity and perseverance, they have a progressive nature, may be accompanied by caloma and the formation of honeystones.

Pathogenesis of constipation at the child

With long-term finding of the wheel masses in the colon, there is an increased absorption of their liquid part and the seal, which leads to damage to the mucosa and pain during defecation. [8] [nine] It makes the child forced to hold back to emptying.

Expansion of colon

With frequent delays, the sigmoid and direct divisions of the colon are dilated (expand), the susceptibility of the nerve ending decreases [8] [nine] What leads to the progression of constipation and their chronicization.

Against the background of increased expansion of the rectum, the tone of the anal sphincter decreases [one] [8] As a result, the fluid flows down the sealing feces and without defecation flows through the hypotonic sphincter (calomase) [one] [8] .

Calomeazania

As the frequency of constipation increases, a disorder of intestinal microbiot is developing, which enhances the pathological state. [7] [ten]

Classification and stage of development of the reap part of the child

At this time, there is no unified generally accepted classification of constipation.

By origin, it is distinguished:

  • Primary constipation - due to congenital developmental anomalies;
  • Secondary constipation - those who appeared as a result of diseases, injuries, the actions of drugs, etc.;
  • Idiopathic constipation - disorders of intestinal motility due to different reasons, including alimentary (due to defective nutrition). [one] [four]

By the time of occurrence, distinguish:

  • Acute constipation - the absence of a chair for several days, which arose suddenly; [one] [five]
  • Chronic constipation - Regular reduction in the number of acts of defecation for three months or more. Other aspects of chronic constipation are long tension during defecation and incomplete emptying of the intestinal tract, painful defecation and sealing chair to "sheep", calomaase or enchnoze (incontinence of feces), and cavalous masses that are palpable in the course of the intestinal tract. [6]

According to the ICD-10 (international classification of diseases of the tenth revision), it is customary to distinguish between the syndrome of the irritable intestine and the functional constipation of different etiology. [2]

In addition, by type of violation of the motor function, constipation is divided into:

  • hypertonic - are a consequence of transferred infections or psychological overloads, and also occur during neurosis, pathological disorders that contribute to the preservation of the tone of the sphincters of the rear pass, eating food rich in cellulose;
  • hypotonic - may accompany such conditions as Rahit, hypotrophy, endocrine pathology (hypothyroidism), as well as a sedentary lifestyle. [2] [four]

Functional constipation - more than 90% of all cases of constipation. [four] [6] [8] [nine]

It is very important to distinguish constipation according to the degree of compensation:

  • Compensation - Defing 1 time in 2-3 days, preservation of urges, stomach pain is not disturbed, no meteorism, constipation is easily corrected by food;
  • Subcompensation - Defing 1 time in 3-7 days (only after receiving the laxative), can disturb pain in the stomach and bloating;
  • Decompensation - constipation more than a week, lack of urges to defecation, pain and abdomen, general manifestations of fell intoxication, defecation after the enema.

This classification according to the degree of compensation is necessary for a doctor to determine the tactics of treatment or referral to a consultation to a proctologist or surgeon. [one]

Complications of the constipation of the child

Long-term compression that has intestinal contents with a stitch, can lead to a tensile and lengthening of the colon, violation of blood supply. Also, children are increasingly haemorrhoids, paraproititis, colitis, although we are accustomed to consider these problems with "adults".

With a part of the outline, the rectum loss may occur.

Launch of the rectum

The constipation provoke and strengthen the imbalance of intestinal microbiotes, which is expressed in the change in the ratio of useful and conditionally pathogenic microflora and manifests itself at the child with a decrease in immunity, signs of insufficiency of trace elements and vitamins, swelling of the abdomen and the poor smell of mouth.

Callery stagnation leads to increased suction of toxins and microflora metabolism products. This is evidenced by signs of intoxication: fatigue, decrease in appetite, sleep disorder, skin manifestations.

Diseases of other organs of the gastrointestinal tract, such as reflux enteritis, stomatitis, biliary disease, gastritis and others, may also occur as a result of persistent constipation.

When constipation threatens the patient's life

Threatening signs when constipation:

  • nausea, vomiting (manifestation of intoxication);
  • urine delay (squeezing by the urinary tract with key masses);
  • The general weakness, vomiting, temperature rise, nausea, tachycardia - signs of intestinal obstruction, peritonitis, which require immediate surgery.

Diagnosis of constipation at the child

When need to consult a doctor

  • The chair is no longer three days, while the stomach hurts;
  • During defecation, the rectum and hemorrhoids fall out; There is a fracture of the rectum;
  • Blood and mucus stands out with the feces;
  • There is a bloating of the abdomen, the extension of gases is broken;
  • The body temperature is increased, hurts belly, vomiting;
  • Defecation is difficult for more than three weeks.

Collect Anamneza

When collecting anamnesis, the doctor will task the following questions:

  • What does a child eat, whether vegetables and fruits eat, is it enough liquid enough?
  • How physically active is physically active, does the moving games play?
  • Does the child have accompanying problems with the endocrine or nervous system?
  • How long is the child suffers from constipation, what measures were taken before, were they effective?

Physical examination

The survey is carried out in order to determine the causes and mechanism for the development of constipation, as well as the exclusion of congenital or acquired organic pathology.

Inspection begins with a finger survey. At the same time, the population of the ampoule of the rectum is determined, the state of the sphincter tone, the presence of anatomical damage (cracks, stenosis), the presence of bleeding. In case of gyrolshpring disease, the sphincter tone is increased, with chronic constipation, calomase - reduced.

Lab diagnostics:

  • coprogram;
  • analysis of feces on dysbacteriosis;
  • Common and biochemical blood test.

Endoscopic examination (colonoscopy, rectoroscopy) is performed in order to estimate the state of the intestinal mucosa and exclusion of inflammatory processes.

Colonoscopy

With the help of radiography of the organs of the abdominal cavity and irrigography, you can see the structural and functional features of the intestine. If, with hypertensive constipation of the intestinal lumen, the Gaustra is strengthened, the emptying is normal, then with hypotonic, the expansion of the sigmoid and rectum is observed, emptying is very slow down.

Violations of the anorectal zone in children are detected using pressure hametry and sphincterometry.

Anorectal manometry

In a comprehensive study, ultrasound diagnostics of the state of the intestine, hepatobiliary system, pancreas and stomach are used. Given the neurological nature of constipation, a neuropathologist is needed.

Differential diagnosis

When diagnosing is very important, it is very important to carry out a comparative analysis of diseases and states similar to the clinic with constipation.

First of all, it is necessary to eliminate diseases having organic pathology (Girshprung disease or agangliosis). With a given disease, the innervation of the colon section is broken, which may be congenital or acquired pathology. Congenital aganglioosis manifests itself from the first year of life, the acquired may occur after any infectious disease of the intestine. The larger the length of the site with impaired innervation, the earlier the disease occurs more hard. In case of hyrshprung disease, conservative treatment is ineffective. There is a progression of constipation with the formation of felling stones, an increase in the size of the abdomen, the development of colitis. Treatment of the disease - operational.

Girshprung disease

Baby constipation treatment

Main directions:

  • Change of lifestyle, behavior;
  • dietary recommendations;
  • medication treatment;
  • Treatment of herbs;
  • balneotherapy;
  • Bos therapy (biologically feedback);
  • Physiotherapy, LFK (therapeutic physical culture).

Increase motor activity

The basis of the treatment of constipation - a change in lifestyle: walks, visiting sporting events, active games in the fresh air. In particular, it is necessary for children for a long time sitting at a computer or a TV. These changes should be an attractive alternative to their everyday pastime. [one] [7]

Dietary recommendations

  • Increase the fiber in the diet of the child. Rational food should include high-quality foods containing food fibers (cereal cereal, wheat bran, berries, baked apples, fruits and vegetables). The use of refined and easily-friendly products must be minimized. [four]
  • Selection of baby blends. Babies that are on artificial feeding are useful to children's mixtures, which contain a gum of a horn tree ("FRISES", "Nutrilon Antirefluorus"), fermented milk mixtures ("nan milk"), mixtures with lactulose ("Bifidus") and others. [2] In addition, it is necessary to introduce adhesiveness of appropriate age.

Increased fluid consumed

In the treatment of constipation, it is important to control the water regime. Water is necessary for the formation of feasible masses and facilitating their intestinal passage. If the water is not enough, the caller becomes more dense. Drinking liquid is better in half an hour before meals or two hours after feeding.

Preparations

  • Prebiotics containing lactulose ("Duhalak", "Portalk"), "Hilak Forte", "Eubikik", monoproprobiotics ("Bifidbacterin", "Probifa"), polyprobiotics ("Bifiform", "Bifidum Bag", "Maxirak") - Course treatment (3-4 weeks);
  • choleretic preparations ("Holosas", "Hofitol", "Galstina");
  • laxatives;
  • Based on the copron, enzymes ("Creon", Pangrol, Mezim) are prescribed - coursework (two weeks);
  • In spastic constipation, antispasmodics are appointed ("Papaverin", "DroTaveberin", "Buckopane", "Duspatalyn"). [one] [6]

When applying laxatives should be remembered by the following rules:

  • Prolonged use of laxatives is not recommended.
  • Doses of the laxative must be selected individually.
  • We must try simultaneously not to accept (not prescribe) drugs that act at different levels of the gastrointestinal tract.
  • In childhood, it is possible to use only those drugs that do not cause addiction ("Lacculose", "Forlax", "Eubikor", sea cabbage, etc.).

Bos therapy lies in the teaching of the child conscious regulation of the tone of muscles of the pelvic bottom.

Physiosocations include electrophoresis, SMT (sinusoidal modulated currents) and reflexotherapy.

What can not be done when the child has constipation

When the child has constipation, it can not be scolded and make forcibly sitting on the pot. It is impossible to give some foods that hovering the intestine motorcycle: quince, pear, persimmon. It is necessary to reduce the amount of flour and meat food.

Urgent measures

Before contacting the doctor's doctor, you can give a laxative preparation, put a candle or make a microclism.

How to make a child enema

Cleaning enema is carried out to release the lower departments of the intestine from the roaming mass.

The technique of execution of the belly is not difficult, it can be done at home. But it is desirable that the first time the procedure controls the health worker.

The room where the procedure is carried out should not be cold. It is necessary to prepare a pear in advance of the desired volume. The temperature of the injected fluid should be from 22 to 26 . If the child is under the year, then it should be put on the back. Older children lay on the left side. Pear need to fill with liquid, release air, lubricate the tip with a vaseline or children's cream. The upper buttock is lifted and entering the tip of the pear into an anal passage by 3-5-7 cm (depending on age). Squeerating the pear, enter the contents. After the seizure of pears, squeeze the baby's buttocks for a few minutes.

Empty learning intestinal

With the impaired functioning of the pelvic bottom muscles, the effective method is bos therapy. The goal of therapy is to teach the patient to control the muscles of a small pelvis and a locking apparatus of the rectum. Patients may be older children who can understand the task.

Position: Lying on the side, the sensor connected to the anal hole is inserted into the anal hole.

Child's task: enhance muscle voltage to appear or increase any animation effect on the screen.

The duration of therapy: once a week for five weeks.

Folk remedies

When the constipation will be useful to use mixtures of dried fruits (figs, kuraga, prunes), baked apples, iodine-containing fruits (Kiwi, Feichoa).

Forecast. Prevention

When eliminating the predisposing causes and adjustment of defects, it is possible to achieve trouble-free defecation and changes in the nature of the feces. Independently carrying out treatment, using only lightweight drugs and enemas, it is impossible, as this may lead to gravity and chronic state. [ten] [eleven]

Physical activity, massage, rational nutrition and a favorable psychological situation are needed for the prevention of stool delay.

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