Many parents concerns the question whether it is necessary to put the enemas in chronic constipation. It should not be done too often, since the enema oppresses the natural urge to emptying, which violates the formation of a defecation reflex. But epizodically put the enemas after all, by following all the rules.
For newborn kids (up to one month), the volume of the enema is not more than 30 ml. For children aged from one to three months, this volume can be increased to 40 ml. To the kids to six months, you can put enemas with 90 ml of liquid, and from six months to a year - 120 ml. Water is worth using room temperature. It may sometimes seem that the complete emptying after the procedure did not happen. No need to hurry and do another enema. Usually, after a while, a child appears in a child.
You also need to give a baby enough liquid. For the treatment of an atonic constipation perfectly helps the abdomen massage clockwise. You can use laid out on the stomach or poorly pronounced tactile irritation of the anal hole. For the treatment of spastic constipation, it is best to use special candles, which includes glycerin. It is not recommended to introduce any third-party objects into the rectum.
Proper treatment of chronic constipation in children cannot be carried out without a mode. Try to teach the baby to empty always at the same time. To stimulate a defecation, you can give the child to drink fruit (especially apple) juice, cold water.
- Vaseline oil . It is characterized by hypoallergenic properties and has a light laxative effect. Due to the fact that the petroleum oil is valid only in the wise of the intestine and not absorbed, the wheel masses are perfectly softened, which facilitates their way out. It is not recommended to replace other oils, as they can harm the baby's health. The active ingredient of the drug is liquid paraffin.
Vaseline oil is shown for use in chronic and other types of constipation in children and adults, poisoning with some poisons (in particular fat-soluble). It is contraindicated in the inflammatory process in the abdominal region, intestinal obstruction, acute feverish states, individual intolerance to the drug.
With long use, the intestinal tone can decrease. Among the side effects also highlight problems with digesting food. Due to the fact that the vaseline oil does not allow suction fat-soluble vitamins, hypovitaminosis can develop.
In chronic constipation in children, the drug must be taken inside in the dosage of 1-2 tablespoons twice a day. Please note that the oil will only affect the five-six hours after the reception. Therapy can be carried out no longer than five days.
It should also be remembered that the vaseline oil passes through the anal hole, not absorbing the body, so it can pollute underwear.
- Lactulose syrup . This drug is the most popular laxative for newborn children. Lactulose is a commonly received Disaccharide, which is absent in wildlife. Due to the fact that this substance is not absorbed by the organism, it is completely safe for human health. Penetrating into the colon, lactulose becomes a subraction, in which beneficial bifido and dairy bacteria perfectly breed. They gradually turn it into organic acids, which are distinguished by a laxative action.
Lacktulose syrup is the so-called osmotic laxative. The mechanism of its action is based on the phenomenon of the special properties of water to penetrate through the semi-permeable membrane from the weak saline solution to concentrated. This property is called osmosis. Osmotic substances help to delay water in the intestines, which increases the volume of cartoons and improves peristality. This is enough to obtain a weak laxative effect.
Lacktulose syrup is distinguished by a sweet taste, are perfectly transferred to children and can be used for a long time. You can buy a drug in any pharmacy without a recipe. It is worth remembering that the positive effect occurs only on the second day after receiving the means. Treatment is recommended to start with small doses, gradually increasing them. Children up to the year daily dose is 5 ml of syrup. Babysham from one year to seven years - up to 10 ml, and from seven to twelve years - 15ml. Adults can also take lactulose in a dosage of 15-30 ml per day.
When taking too large doses of the drug, side effects are possible. They manifest themselves in the form of diarrhea and abdominal pain.
- Candles with glycerin . Excellent laxative tool for local applications. The drug has irritable effect on the rectum than stimulating the intestinal peristalsis. It also helps softening feces. It is used rectally on one candle a day in twenty minutes after receiving breakfast.
With prolonged use of candles, the development of side effects is possible: an allergic reaction, skin irritation in anal passage, weakening the natural emptying process. Candles with glycerin, as a medicine against chronic constipation in children, are contraindicated with hemorrhoids, in the presence of cracks in anal passage, tumors and inflammation of the rectum, individual intolerance of glycerol (active component).
- Microlax . The drug is produced in the form of a viscous solution, which is used to carry out microclism. It is considered one of the most effective funds from chronic constipation in children and adults. Microlax is a combined drug. Its active ingredients are: sodium laurylsulfoacetate (with diluting effect), sodium quotes (for displacing bound water in cartoons), sorbitol (for enhancement of the laxative effect), glycerol (to improve the motility of the rectum).
After using the drug, the positive effect occurs after 15 minutes. The means is shown in chronic constipation and when preparing for the study of the gastrointestinal tract. There are no contraindications to mycolaxs. It can be used without fear, even in the treatment of constipation in newborns. Among the main side effects are distinguished: possible allergies, irritation, burning in the rectal area. Usually for treatment there is enough single tube (5 ml of the drug).
Typically, the physiotherapeutic treatment of chronic constipation in children is carried out comprehensively with a special diet (food rich in food fibers). The main methods here are the following.
- Treatment with mineral waters . Physiotherapy includes the use of special mineral sulfate water (bitter salt, sterling mineral and mixed with sulfates sources). Usually, to obtain a laxative effect, it is necessary to increase the dose level of SO4 (up to 3 g).
- Physical exercises . Such a method of treatment is suitable for children from seven years. For the treatment of constipation is very important to actively move. In addition, you need to do special exercises. First of all, you need to deeply pull the stomach, and then let him go at a slow pace. It is necessary that the child considers to ten. Repeat the exercise at least five times a day.
In order to stimulate the evacuation of the chair before each expected emptying, you need to do the following exercise: breathe deeply air, drawing the stomach, and then throw it away, exhausted. Exercise repeat ten times.
- Massage . For the treatment of chronic constipation, the effective method is a colon massage. Its purpose is to stimulate the intestinal motor activity. It is very important to make such a massage correctly: all pressure and touch are performed strictly towards the anal hole. Each part of the colon must be massaged up to five minutes. Masseur is obliged to put pressure on inclined, synchronously with the breath of the patient.
For the treatment of chronic constipation in children, there are several proven and efficient folk agents.
- Vegetable oil . Before the first feeding from the morning, it is necessary to give a child vegetable oil (sterilized). On the first day - 1 drop, and then gradually increase and reach half of the teaspoon. Using until the normal intestinal operation is restored.
To sterilize vegetable oil, it is necessary to pour it into a jar and put it in cold water. Press with water and can be placed on a weak fire and boil. Leave the bank for another 30 minutes until water is boiled.
- Prunes . Fill half a kilogram of prunes with 3.5 liters of water and boil for 25 minutes. Give the brave to cool. Then add 50 g of the crust of the cortex and boil once again (25 minutes). Immediately cool down and add 200 g of hips from a rosehip (can be purchased at the "Holosas" pharmacy). Take this drink before bedtime at half a cup.
- Lemon and yolk eggs . Take a small lemon and squeeze the juice from it, add one crude yolk and mix with a glass of orange juice. This medicine is delicious and helpful. Perfectly helps with chronic constipation in children.
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Treatment of herbs
- Senna . Very powerful laxative. To get a positive result, you need to mix 2 teaspoons of SENNA with 100 g of prunes. Add three glasses of boiling water and welcome. Insist for three hours, then strain. Use three tablespoons every hour before the disappearance of the constipation. There are no contraindications for use of such a drink. Relief usually comes six to ten hours after use.
- Garbage . Mix collecting from the effects effective in constipation (licorice, fennel, alta and flax). Grind to get powder. Brew one teaspoon of such a collection in a glass of water and give it. Drink before bedtime at half a cup.
- Mecaler and Aloe Vera . Remove the faith from Aloe and the meal of juice and mix it with honey. To obtain juice, it is best to use a young plant (not over 3 years old). To do this, cut it out of the leaves and put a few days in the refrigerator. Get them and put them under the press. Juice take a whole day on one teaspoon.
- Atizum nitrikum . The composition of this homeopathic preparation includes nitric acid, which effectively acts on all holes in the human body, including anus. It is shown for use if the roast masses are strongly damaged by the rectum, with chronic constipation, with cracks in the anal hole. Take after eating 5 grains twice a day. The duration of treatment is two or three weeks.
- Aluminum . The drug is a purified anhydrous aluminum oxide. It is used in constipation that are characterized by the loss of the tone of the rectum, very effective in the treatment of chronic constipation in children, especially in a complex with another Brionium preparation. Consume 5 grains per day before eating twice a day. Treatment continues from two to three weeks.
- Brionium . Active current component - a perennial bronium plant (or white space). Granules are absorbed three times a day. Dosage depends on the age of the patient. For example, children under two years can be given no more than two granules per day.
- Lycopodium . It has painful, anti-inflammatory, wound-healing, antiseptic, enveloping effect. From this drug make tinctures and decoctions, which perfectly help with chronic constipation in children.
Diet with chronic constipation in children
If your child has a constipation, do not hurry to apply famous laxatives or to put enema. All this can be avoided if you eat right.
Water is considered the most important component in the treatment of constipation, since dehydration dries the rectum mucous membrane and leads to harvested paths. If you give the kid enough of the usual water, it will help him get rid of chronic constipation and make a stool softer. Remember that you need to drink at least 2 liters of water per day (adult).
Do not forget to include in the diet of the child products rich in vegetable fiber. Thanks to them, you can improve the intestinal motorcycle. The fiber perfectly stimulates the contracting processes, so food is faster through the body. In addition, it displays toxins and slags. The most effective products are considered:
- Dried apricots.
During the constipation, products that help clean the body are also considered useful: bran, dried fruits, rye bread. No less effective is the quashed and fresh white-baked cabbage, legumes, broccoli. Breakfast is best to give a child vegetables, fruits, making it salads with sour cream or vegetable oil.
An indispensable product with a diet from chronic constipation in children are whole grain porridge (pearl, buckwheat, barley, oatmeal, wheat). Do not forget about our prostrochu, kefir (better one-day).
An exemplary diet menu in chronic constipation are the following:
- Breakfast: vegetable salad, seasoned sour cream, beans (boiled), oatmeal on milk, fried eggs and tea.
- Second breakfast: fresh apples.
- Lunch: Vegetable soup, stewed cabbage and boiled meat, compote on dried fruit.
- Afternoon person: a handful of prunes (can be replaced with dried fruits to taste).
- Dinner: Cabbages of vegetables, buckwheat, cottage cheese and tea.
- Before bedtime, be sure to drink a glass of kefir.
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Packs in children is a serious problem. Basically, parents use ready-made pharmaceutical preparations to solve it. There are other safe alternatives: making an adjustment in the power scheme, in the diet.
In order to get rid of the constipation in children, you can start with the use of fresh vegetables and fruits. You also need to consume an adequate amount of water, exercise.
Problems from the digestive system are the main reason for advice with pediatrician. Popps for the child may be accompanied by painful sensations, in the absence of a complete treatment, to cause other complications in the body.
How to identify the problem
The main signal of this problem will be significant changes in the normal operation of the digestive system. The child can go to the toilet 1-2 times a week, dry and rude feces. Also among the signs of the problem, the bloating and pain in the intestinal pain.
Not in all cases to solve the problem will have to buy laxatives in the pharmacy. Before entering the use of drugs, it is necessary to adjust the diet, use natural agents.
Survey of kids having delays with a chair controls the pediatrician. If necessary, the child is sent to a consultation to the children's gastroenterologist. A professional analyzes anamnesis of the disease, considers the accompanying diseases, changing the power scheme. To establish the reason for the appearance of constipation of the child, laboratory studies are conducted, an inspection of the gastrointestinal tract.
Among the modern methods used to identify the causes of constipation in kids:
Finger examination. First of all, the state of the rectum is analyzed, cavalous masses, sections with maximum soreness are evaluated. The doctor feels belly, reveals spasms, bloating, changes in the sizes of the sigmoid gut.
The abdominal ultrasound allows you to identify signs of inflammation, neoplasms, defects in the digestive tract.
X-ray is used to determine the extensions of intestinal loops, search for intestinal obstruction.
Laboratory indicators: liver test, biochemical blood test, hormone analysis.
The coprogram identifies the presence in the feces of undigested fragments of food, leukocytes, erythrocytes, fatty acids. In order to exclude dysbacteriosis, bacteriological sowing of Kala is carried out.
Recommendations for treatment
We offer recommendations for parents to eliminate the child of constipation.
Factors due to which a problem may arise, a lot:
To eliminate constipation, it is first important to adjust the power.
1. Introduction to the daily diet of the maximum amount of fiber. This nutrient stimulates digestion processes. With its insufficient content in the children's body, constipation arise.
Among products rich in vegetable fiber:
fruit with peel;
2. Using the minimum amount of sugar and sweet products. When consuming the excess sucrose, the digestive system gives a failure. Pretty common is constipation from kids who eat a large number of candies and sweets daily.
3. You need to teach the baby to drink drinking water. With a lack of drinking water, a slowdown in digestive processes is observed. The fluid contributes to an increase in the volume of plant fiber, the chair is softened.
4. Full physical activity. Regardless of whether the child will play with peers, or enthusiastically, the blood circulation is incentive during training, which contributes to the improvement of digestive processes. An excellent addition to the right regime and diet will be the participation of the baby in physical activity.
5. You need to form a kid for the use of the toilet. Since the kids are afraid to sit on the toilet, parents must form a similar habit in children. The guys who do not know how to use the toilet, try not to attend the sanitary room.
It is important to learn without some pressure. The child must get used to the right pose on the toilet, learn how to use the drain tank. With the first call, you need to go to the toilet, do not hold back the natural desire of the body empty the intestines.
Apply the laxatives is recommended for chronic constipation (before use you need to consult with a pediatrician). If the problem occurs periodically, it is better to restrict ourselves to natural means.
Plum juice. This fruit has an excellent laxative effect, contributes to the improvement of digestive processes, is a means of preventing the consequences of constipation. The kids are enough to give 30-50 grams of juice, collecting it with the same amount of water.
Eating empty stomach. This fruit is ideal for the rapid elimination of children's constipation. It is enough to eat 5-8 grapes.
Natural honey. At the age of the year you can breed honey in water. Thanks to natural enzymes, honey positively affects the splitting of substances, facilitating their assimilation by the body.
Apple juice. Pectin and water help eliminate such a problem as constipation. With daily use, the child is 100 ml of apple juice, or some problems with the emptying of the intestine will not go and speech.
The simplest and safest elimination of constipation in children is to change the power. Replacing the processed food by organic products by entering the fruit in the menu with the laxative effect, the prevention of constipation can be carried out.
Reasons for constipation in babies, children under 7 years
Due to the anatomy-physiological imperfection of the digestive system and the influence of numerous risk factors, the single cause of the disease is not established. Baby constipation is a complex, polyethological disease, having individual mechanisms for development and manifestation. The impact of risk factors and a number of other circumstances lead to a slowdown in transmitted intestinal activities, cluster of dense masses in distal departments, the emergence of characteristic symptoms of pathology.
Basic predisposing factors
Dominant causes of constipation
These include the following factors:
- Nutritive disorders and disorderly feeding;
- underestimation of the individual food addiction, frequent mixture change;
- violent and excess feeding ("to the last drop");
- Introduction to the diet of foods that the child of this age cannot adequately digest;
- Early administration of adhesiveness and the transition to solid food;
- selective meals (deficiency in the diet of dietary fibers, impaired balance between food ingredients);
- Droinated nutritional stereotype (disorderly and episodic food).
These include the following factors:
- low motor activity, tight swab, the use of diapers with tight straps, etc.;
- Syndrome "Fear of the pot";
- Pedagogical errors in education;
- psychological depression, increased impactivity;
- non-defined stereotype of defecation;
- Low stress resistance and lability of the child's character.
Pathological states of the organism
This includes the following:
- organic bowel disease (Girshprung disease, Dolicholone and Dolichosigma disease (lengthening of intestinal departments), the cracks of the anal hole, hemorrhoids;
- Iron deficiency;
- neurological diseases (myopathy, paresis, paralysis of various origins);
- In girls, inflammatory processes of internal genital organs;
- Endocrine and metabolic diseases (diabetes mellitus, hypothyroidism, fibrousosis).
Using certain groups of medicines
- codeine and its derivatives;
- sedatives (phenobarbital, antidepressants, derivatives of phenothiazine,);
- Antacids, etc.
Types of constipation
This type is temporary. Baby constipation occurs infrequently, only a few days.
It can be caused by a change in a diet or day, travel, lack of exercise, diseases or medication.
It is possible to facilitate the condition of the child with acute constipation with non-delicate laxative, exercises or a high-tier diet.
Popps in children last for more than three months, and sometimes continue for many years. Disorder violates the daily life of the child. It does not take place without changing diet and physical exertion, requires the use of medical drugs released by a doctor's prescription.
Functional (idiopathic) constipation implies that there is no identifiable causal organic state.
This type of disorder usually begins after an neonatal period. Almost always there is a deliberate or subconscious hold of the chair. Acute form often precedes chronic flow. The chair becomes hard, smaller in volume and difficult, which leads to irritation in the anal hole and the appearance of cracks.
In children under 3 years old, forced or too early teaching a pot can initiate a stool delay. The older children have persistent constipation can develop when a child is in a situation that does not allow empty the intestines, for example, at school.
Since the act of defecation becomes painful, there is a voluntary retention of feces to avoid pain. Next, calling for defecation disappears, since the rectum contains all the contents. This vicious cycle is gradually aggravated, as it increases the volume of the feces that must be output.
In infants with a delay in the act of defecation, visible changes are minimal. With prolonged intestinal dysfunction it is possible to detect an increase in the size of the abdomen, due to the accumulation of carts in the distal gastrointestinal departments. Children complain about the feeling of awkwardness, completeness and cutting in the stomach, especially in the left side.
If the fecale masses of the patient in the anal region, there is a sharp pain in the patient in the anal field, which is due to the appearance of supervisors and cracks. The child is subsequent not solved on the act of defecation, accompanied by painful sensations, begins to spontaneously delay the intestinal emptying, due to a long constipation, and sometimes it is lost a deflexion reflex.
Diagnostics are carried out in two stages.
At the first stage, the doctor carefully collects and analyzes the history, clarifies the factors and somatic disorders that contribute to the formation of the disease, conducts a physical inspection.
Anamnese collection often helps to distinguish functional constipation from Girshprung disease.
It is especially important to find out when the child first had a chair after birth. Most children with girshprung disease arise constipation immediately or shortly after the appearance of the world. More than half of the babies with this pathology, there are no MECONOM (original feces) in the first 36 hours of life.
The doctor must also ask questions about the specific symptoms of the constipation of the child, about the beginning and their duration, are there soreness and bleeding associated with defecation.
In infants, functional constipation is often developing due to dietary changes (for example, shiftBreast milk
To the mixture, add solid products in the menu, replacing the mixture to whole milk).
In children under 3 years old, idiopathic constipation arises during a teaching of the pot. At the child of early and preschool age, the latency of the chair can develop after peeling dermatitis or dehydration.
Elder children have functional constipation not rarely develop when entering school, because they refuse to empty the intestines while they are at school.
The most important part of the physical inspection is a rectal study. The doctor must spend it from any child with chronic constipation, regardless of age to eliminate the main anatomical anomalies that can determine constipation, such as:
- Anal atresia (hole infection) and urethroperinal fistula (hollow channel on the crotch skin);
- obstruction of the intestine (the effect of calmonged rolled);
- Girshprung disease.
Also, you should pay attention to the size of the anal channel, the size of the rectum and the presence of any intravertal masses. If the rectum of filling in the chair, it is necessary to note its consistency.
Among children with Girshprung disease, the direct intestine is usually quite small and empty. After the infant survey, the baby may have a liquid stool, since the functional obstruction is temporarily weakened.
A child with functional constipation has a direct intestine, as a rule, is increased, and the chair is present only for an anal edge.
It is important to confirm the presence of anal (skin) reflex. To call him, the doctor strokes the skin on the crotch. In response to stroking, the external anal sphincter will be compressed. The absence of this reflex may indicate an anomaly with peripheral sensory or motor nerves, or central connections encountered by the reflex.
The second stage of the examination is instrumental. It is initiated if the designated therapy did not have a sufficient effect, the clinical picture remains, and the doctor doubts the functional nature of the pathology, suspecting the presence of anomalies of the distal gastrointestinal department, Girshprung disease. Apply a reorgano- or colonoscopy and irrigography.
In accordance with Roman Criteria II, the functional constipation is diagnosed if the patient has at least two of the manifestations of the manifestation:
- no defecation of at least 25% of the usual time of measurement;
- constipation continues at least a year without the use of laxatives;
- the need for excessive fit;
- chair lumpy or solid;
- The feeling of not complete emptying (this criterion cannot be applicable for breast and early children);
- Less two acts of defecation per week.
If there is only irregular defecation, and the listed constipation criteria are missing, the functional latency of the chair is diagnosed.
In patients in parents, in most cases, the functional latency of the chair is observed, and at an early age, the functional constipation is more often.
How to help your child when constipation
The treatment of constipation in children is a rather complicated and long-term task.
Changing the diet
Dietary changes, such as an increase in fluid and carbohydrate consumption, are usually recommended as part of the treatment of constipation.
Poor absorbed sugars (for example, sorbitol) are found in many fruit juices (for example, from prunes, pears, apples). These sugars increase the frequency of the chair. If the child has constipation, it is recommended to comply with a balanced diet, including solid grains, fruits, vegetables and abundant fluids consumption.
Exception of cow milk
It should be excluded from the ration of infants and children of the early age of the protein of cow milk during a certain period of time, since it aggravates chronic constipation.
Unnecessary or inefficient diet changes
It is not required to translate the child to the milk mixture with a low content of iron. In several studies, it is shown that the use of mixtures rich with iron is not associated with the development of constipation.
There are also no reliable information that the use of probiotics is effectively in the treatment of constipation in adults and children.
Increase motor activity
For adults and children, daily physical exertion will help digestion and facilitate constipation.
Regular motor activity favors the rapid movement of food through the colon and helps the intestine muscles to shrink, moving waste.
On the other hand, the lack of activity leads to the weakness of the intestine, which makes it difficult to regularly exhibit feces.
For children, one of the best exercises is a walking. Pay 30 minutes a day walking, especially after eating.
Swimming and cycling on a regular basis will also be useful.
Medical therapy. The main groups of drugs in the treatment of constipation in children
The basis of pharmacological constipation therapy is to use a sufficient number of laxative to achieve the desired effect. Continuous use of laxatives may be required for several months until the connection between the defecation act and the pain disappears.
- polyethylene glycol;
- Magnesium hydroxide;
- magnesium citrate;
- Sodium phosphate.
Preparations contribute to attracting water from cells, which leads to the expansion of the intestine and the strengthening of its peristalsis.
Laxatives with a stimulating effect:
Preparations of this group enhance peristaltic activity in the gastrointestinal tract. Most of these agents also stimulate the release of salt and water in the thick intestine.
The drug saturates with water and fat, contributing to softening.
Early studies show that daily use of herbal tea based on Fennel, Anis, elderly and Senna can reduce constipation within 5 days.
Fennel seeds stimulate the movement of the muscles in the digestive tract, which leads to healthy digestion and regular acts of defecation. Fennel seeds also prevent the formation of gas in children.
Application of a cleansing enema during constipation in children
In some cases, you can use the enema to help eliminate constipation. However, this should be done only on the recommendations of the doctor.
To this method, it is impossible to resort constantly, since the regular use of the enema can prevent the intestine muscles to perform their work on the removal of feces.
It is also possible to develop an electrolyte imbalance, which will require additional treatment.
Complications of constipation in children
Serious constipation can lead to more severe states, including such as:
- rectal bleeding due to constant voltage for the intestinal emptying;
- Anal crack is a small wound in the area of the rear pass;
- Hemorrhoids - increased, inflamed blood vessels of veins in the rectum;
- Called challenge when the dry callers accumulates in the anus and the rectum, which leads to obstruction.
When constipation threatens the patient's life
Contacts itself does not lead to a fatal outcome. But with a continuous latency of the chair, certain changes may occur that cause death.
Studies have shown that patients with constipation are in the risk of oncological diseases. The digestive tract of a person passes through itself thousands of carcinogens.
With irregular emptying of the intestine, these chemical compounds are delayed in the body, which leads to the appearance of atypical cells. In patients with constipation, the tumor is often found in the places of concentration of feces - the spley and the liver corner, a sigmoid and blind intestine.
Prevention of constipation of child
- It is necessary to offer children with high-content of fiber, such as fruits, vegetables, beans, wholegrain flakes and bread. If the child is not used to a diet with a high content of coarse fiber, then you can start with the addition of several grams of fiber daily to food to prevent the appearance of gas and bloating.
- You should encourage a child to drink a lot of fluid.
- Regular physical activity stimulates intestinal peristalsis.
- A visit to the toilet should be comfortable for the child. You can give the baby a bench for feet so that he has enough support for comfortable intestinal emptying.
- It is important to remind a child to never ignoring the urge to the act of defecation.
The constipation can affect people in any age group, and ultimately this can lead to many problems such as hemorrhoids, anal cracks, cavalry. Therefore, it is important to change the habits of food, as well as drink a lot of fluid to prevent this disease.
Publishers in children A frequent reason that causes substantial discomfort in children and anxiety of parents. According to various data, constipation is the cause of a doctor's appeal in 3-5% of cases. Revealed constipation in 1-30% of children.
A short episode of constipation in children is often found and usually lasts only a few days. Proper diet and sufficient liquid volume - this, in most cases, is enough. However, some children develop chronic constipation (permanent and heavy). Regular linen contamination (often erroneously taken for diarrhea) may mean that the child has chronic constipation.
Normal chairs in children
The frequency of the chair in children is inconsistent, and varies in fairly wide limits. Relatively generally accepted are the following statements and norms:
- The first defecation (emptying of the intestines from the megonia) occurs within 36 hours from birth. In 90% of children, the release of meconium is observed in the first 24 hours from birth.
- During the first week of life, the child has an average of 4 defecates per day. This indicator is very changeable and depends on the type of feeding: artificial or natural.
- Up to 2 years, the average number of defecates can vary from 3 times a day to 1 time in a few days.
- After two years, the number of defecates 1-2 times a day
- After 4 years old - 1 time per day
Despite the above-mentioned indicators, the baby on breastfeeding may not have stool 7 and even 10 days, and it may be the norm. In children on artificial feeding, the variability of the normal frequency of the chair is even higher.
Classification of constipation
- Organic, i.e. caused by any disease
- Functional, i.e. constipation in the absence of anatomical and / or biochemical problems.
It is advisable to divide constipation in children into two large categories:
- Easy and / or temporary constipation, which lasts only a few days. This is a very common situation that can be repeated from time to time.
- Chronic (permanent and serious) constipation. It is much less likely. Its treatment differs from more frequent - lungs, temporary constipation.
- Difficult defecation, or defecation at which significant efforts are needed and / or
- Pain with defecation. and / or
- Chair less often than usual.
The following criteria for diagnosing functional constipation (ROME III) have been developedInfants and kids
- Chair less often two times a week
- Episode incontinence of chair after purchasing hygienic skills
- Previously observed episodes of pronounced stool delay
- Painful or difficult defecation
- Large volume of stool
- Caliac lump of large diameter
The diagnosis is made by observing at least 2 of the six listed criteria within a month.Children aged 4 to 18 years
- Chair less often two times a week
- Episodes of incontinence of stool
- Episodes of volitional delay of stool
- Painful or difficult defecation
- Large volume of stool
- Caliac lump of large diameter
The diagnosis is made by observing not less than 2 of six listed criteria for two months.
What are the reasons for constipation in children?Food and drinks.
Violation of the power mode - the common cause of children's constipation:
- Insufficient content in food fiber feed foods, fiber (coarse part of products that is not digested and remains in the intestine) and / or
- Insufficient fluid flow.
Cal becomes dense, dry and makes it difficult for defecation, when there is little fiber and liquid in the intestines.Conscious stool hold:
The child feels caking for defecation, but resists. This is a frequent cause of functional constipation. You can see it in a child for the legs withdrawn, seats on the heels, or on other similar actions that helps to suppress the feeling of defecation. A long-term conscious hold of the chair increases the volume of the chair and, afterwards, it makes it difficult to exit. There are a number of reasons why children can try to keep chair:
- Previous defecation may have been difficult and painful. Therefore, the child is trying to postpone the defecation, fearing again to experience pain and discomfort. (anal crack, irritation of the perianal zone, sexual violence, hemorrhoids)
- unfamiliar or uncomfortable environment (for example, in public toilets). The child can temporarily turn off the defecation until he returns home.
- Emotional problems, depression.
Diseases leading to constipation in children
There can be quite a lot of diseases to constipate: diseases of the thyroid gland, as well as some intestinal disorders, allergic to the cow's milk can be one of the constipation factors. If the constipation is a symptom of the disease, then, as a rule, there are other signs, because it is extremely unlikely that it will be the only manifestation of the disease. Some medicines can cause constipation as a side effect. Anyway,If the constipation is a chronic problem, you must consult with your doctor.
How can you prevent constipation from a child?
Eating foods with lots of fiber and large amounts of water helps to increase the volume of the chair, but the chair becomes soft, the intestines easily empties. Regular physical exertion also contribute to normal defecation.Food fibers (fiber).
Products containing a large amount of nutritional fibers and fiber
- Potatoes in uniform with bobs beans or vegetable soup with bread.
- Kuraga or raisins for dessert.
- Porridge or other cereals with high fiber, for breakfast.
- Fruits with each meal intake.
- Perhaps you should not allow the child to take candy until it is eating a fruit.
If children do not want to eat food with a high content of dietary fiber - add dry bran into yogurt. Yoghurt will soften the unpleasant taste of dry bran.The drinks.
For the normal functioning of the intestine, sufficient flow of fluid is important. However, some children have a habit of drinking only juice, carbonated drinks or milk to quench thirst. They can sank their appetite and therefore use little food containing a large amount of fiber. Try to limit these types of drinks. Give water as the main drink. Nevertheless, some fruit juices that contain fructose or sorbitol having a laxative action (for example, prunes, pears, or apple juice). It can be useful from time to time when the chair becomes cooler than usual, and you suspect that constipation can soon develop.Some other tips that can help:
- Try to get the child to a certain time of visiting toilet. After breakfast, in front of the school or kindergarten is the best option. Try and highlight enough time so that it does not feel a rush.
- The promotion system is sometimes useful for young children, subject to hold of the chair. For example, a small treat after each successful hike to the toilet. However, try not to make a tragedy from the toilet problem. The goal is that the situation is usual and did not cause voltages - the matter is everyday.
Light / temporary attack of constipation in children and its treatment.
Most episodes of constipation in children last just a few days. Many children are strained to squeeze a bulk or rigid fellow lump. It does not matter much, Cala's consistency will soon return to normal. Treatment of temporary constipation is the same as when preventing constipation.That is, diet
With plenty of fiber, abundant drink, and possibly fruit juice that contains fructose or sorbitol. In some cases, your doctor can recommend a laxative for several days. With the episode of light constipation, the function of the lower intestinal departments (rectum) do not suffer. Thus, you can stop treating laxative as soon as the chair will become easy again. Typically, treatment takes several days. Here is the difference from chronic constipation (see below), where the function of the rectum changes, and laxatives are used by long courses.
Chronic (resistant and heavy) form of constipation
Chronic constipation in children call heavy and continued long-term disruption of defecation. It develops more often in children aged 2 to 4 years, however, it also happens with the elders and younger children. Symptoms and features of chronic constipation include:
- Repeating situations when a child is experiencing difficulties or problems during the empty of the intestine.
- The child regularly dirty underwear with a very soft chair, or faeces in the form of mucus. It is often regarded by parents as diarrhea.
- The child can become irritable, eats little, feels bad, feeling pain in his stomach from time to time, and in general he has a low mood background.
- The doctor often can feel filled with rigid, self-cavalous content, terminal intestinal departments, with palpation of the abdomen.
Next, we will try to explain how chronic constipation can develop, and its symptoms. In particular, why linen contamination is a symptom of chronic constipation. As a rule, the feces accumulate at the bottom of the large intestine. If the chair accumulates, it begins to move into the rectum (the last part of the intestine), which expands. It sends signals around the nerves in the brain, speaking "you need to go to the toilet." When relaxing anus on the toilet, it takes a little effort to "squeeze" cal. But if the child ignore the signal, constrained, then the feces remain in the rectum. Gradually, the intestine is formed a large dense fence lump. The rectum is then expanding and increases much more than usual. This contributes to the formation of a cartoons in which the dense feces will be stuck in the rectum. If the rectum remains worn for a long time, then the normal feelings of urges to defecation are weakened. In addition, the muscular power of the rectal walls is reduced, it becomes "lazy".
Additional portions of Cala are suitable for Kalovoy Komku located in the rectum. The lowest part of the calm lump lies slightly above the anus. Some of these "fresh" servings are diluted and leak out of the anus. It is a dirty baby underwear and bed linen. In addition, some of the soft chair, a liquid chair, from the overlying divisions of the large intestine, can "get around" around a hollow lump. It also seeps out of anus and can be accepted for the manifestation of diarrhea. The child in no way (!) Cannot control this leakage and linen contamination. If the roasting chassis is ultimately fully removed (by enema), it is quite quickly filled with a rigid chair, due to the fact that the walls of the rectum are stretched and weakened.
What is the treatment of chronic constipation in children?
High fiber diet and abundant drink. This is described above, but, as a rule, additionally to this, the appointment of laxatives is required.
Laxatives are usually prescribed if the child develops chronic constipation. The first goal of them is the emptying of the rectum, the resolution of the cavalry. This usually can be done quite quickly, only an adequate dose of a strong laxative. Sometimes laxative candles or cleansing enemas are needed to resolve calm diverge. After emptying the rectum, it is important to continue the reception of laxatives, as prescribed by a doctor.It may be necessary for several months, and sometimes even up to two years.
When a child takes laxatives every day, the following happens:
- The child more often goes to the toilet and has a regular chair. Since it goes to the toilet more often, the chair becomes smaller in volume and softer. Thus, the feces will stand out easier. A child will be free from fear to go to the toilet with a large hard painful lump.
- The rectification of the rectum decreases, and it can gradually return to normal sizes, the functions are restored properly.
The constipation is unlikely to repeat. If the laxatives are abolished prematurely, the cavalous challenge is likely to repeat again in a weakened ampoule of the rectum, which did not have enough time to return to normal size and restore force.There are different types of laxatives that include:
- Substances increasing feces. This is, for example, bran. They make a stool soft but volumetric.
- Softening chairs. These substances dilute and soften the stool. For example, sodium document (which also has a weak stimulating effect).
- Osmotic laxatives. For example, lactulose and polyethylene glycol. These substances retain liquid in the thick intestine by osmosis (reduce the absorption of the fluid into the blood from the lumen of the colon).
- Stimulating laxatives. For example, Senna or sodium document. They act on the muscles in the intestinal wall "squeeze" weaker than usual. In children, hay preparations are not recommended for use.
The doctor will usually advise the use of laxatives. However, there are quite often two laxatives at the same time for several months, if one drug does not give the desired effect. For example, osmotic laxative plus stimulator. Over time, the dose gradually decreases and the medicine is canceled. It is important to continue treatment as long as the doctor advises. Chronic constipation is often repeated if the treatment is stopped too early.
Reasons for constipation in children
Poinons that provoke an alimentary causes arise in the second half of the child's life when an active introduction of the dust is happening. Disorders of feces are due to the predominance of solid products and pounds, a decrease in breast milk consumption. The chair is observed 1 time per day or less often that is uncharacteristic for infants. At the same time, Cal has the form of small lumps that annoy the rectum, because of what the child is crying during defecation.
Older children constipation are associated with insufficient consumption of vegetables and fruits, which contain fiber. Calla delay is provoked by an irrational diet with a predominance of porridge, cottage cheese, meat. The absence of a chair is often due to inadequate drinking regime, especially in the hot season. Cal is long in the rectum, it loses the water, during defecation, dry bug-in calibration masses are released as a cylinder.
Sometimes a chair begins to linger during the period of teaching the baby to use the pot. If parents at this time do not show enough patience and care, each act of feces is accompanied by stress, conventional and reflex reactions arise with the participation of rectors receptors. The child involuntarily delays the feces, with time the frequency of the urges to the defecation is incremented.
Popps in young children cause other psychogenic reasons: constraints when using a pot in kindergarten, inconvenience when visiting the school toilet. The absence of a complete fattefulness of carts is often combined with an enchnozer (incontinence of feces, a pack of panties). With untimely diagnosis and therapy, they can flow into persistent mental problems that continue in adulthood.
Violation of the normal microflora and the growth of pathogenic bacteria is a frequent reason why constipation occurs in a child, because useful microorganisms produce milk acid and stimulate the peristaltics of the intestinal wall. Feling in dysbacteriosis occurs once every 2-3 days, honey masses are scarce, merciful, silent. Sometimes on the surface of the feces you can see a grayish flare. Older children complain about the rice and drilling in the stomach, grasp pain.
With increasing temperature, the children's body intensively loses water through sweating and rapid breathing. Due to dehydration, the feces are becoming very dry, with a trip to the toilet, small lumps are distinguished ("sheep feces"). In the febrile temperature, the chair may be absent for 3-4 days, which indicates severe hyphydrate, to cure that at home is impossible.
Diseases of the rectum
In case of damage to the mucous membrane, the defecation is accompanied by a sharp pain, so the child spontaneously holds back the urge, so as not to experience pain. The situation is aggravated by accumulating a large amount of solid feces in a rectal ampoule, constipation reaches 5-7 days and more. Children impose complaints about unbearable pain in the area of the rear passage and at the bottom of the abdomen, which are enhanced in a sitting position.
When proctitis and paraprojectites, constipation in children are combined with other symptoms: constant twigging or stupid pains without clear localization, lack of appetite, weakness and ailment. For anal crack, the discharge of blood drops from anus during defecation is characterized. With recycled fistulas, along with long constipation, there is a debit of bleeding or purulent contents from the hole next to the anus.
The severity of symptoms depends on the form of Girshprung disease. With a diffuse damage to the large intestine, constipation begin almost immediately after birth, there is no spontaneous defecation in the newborn. The child is restless, constantly screaming, sucks with legs and tries to press them to the stomach. In the absence of treatment, the children's form of pathology disease causes intestinal obstruction.
With a latent or prolonged version of the anomaly, the begging frequency is reduced to 2-3 times a week, the constipation is eliminated after the use of enema. Manifestations more often arise from schoolchildren and adolescents. Stagnation of fenders causes chronic intoxication for which dizziness, headaches, skin pallor, fast fatigue.
Congenital developmental anomalies
Atresia of the rectum is already manifested in the first day of the newborn life: Mekonia does not leave, there is no chair, there is no anal hole. This condition is diagnosed with neonatologists immediately after delivery. False constipation (pseudosorov) pathognomonic for cleft lips and sky. In this case, the defect of the structure of the facial skull of milk and the mixture is poured into the respiratory tract or caused from the mouth. Cala delay is associated with insufficient nutrition.
For Dolichosigma, the appearance of stubborn constipation after 6 months of life is due to the introduction of feeding. First, they are concerned with episodically and last from 2 to 3 days, then the duration and frequency of the stool delays increases. The feces of large diameter, it resembles a "spruce bump", has a sharp evil smell. In 30% of children, constipation occurs between 3-6 years.
Little children do not observe hygiene, so the development of constipation in a child of preschool age is often associated with the ingress of parasites in the gastrointestinal tract. With gelminths, food digestion and intestinal motility are violated. Some of them (ascaris) form large "tangles" in the bowels of the intestine, so during ascariasis there is an obstacle to the promotion of feet. Always revealed a stubborn latency of the chair, the children feel abdominal pain, sometimes vomiting.
The appearance of constipation is characteristic of gastroduodenitis and peptic ulcer. These reasons cause violations of the motility of the gastrointestinal tract, as a result of which partially digested food is longly delayed in the intestine. Connorative constipation, defecation resumes 2-3 days alone or after the edition of the enema. The symptom is repeated regularly, it provokes errors in a diet, stress.
Long-term constipation in children developing against the background of sharp pain in the stomach, tenesmov, typical of nonspecific ulcerative colitis. When clarifications for defecation from the anal opening, blood and mucus are distinguished, the delay in the path masses during the exacerbation reaches the week. The symptom is sometimes replaced by profuse diarrhea, cavalous masses are liquid and silent, contain blood impurities.
With lead poisoning, constipation in a child may be the only symptom. Sometimes there is a spilled soreness in the stomach and a single vomiting. Endogenous causes are also caused by endogenous causes: intoxication of protein decay products, the release of toxins by microbial cells. Strong constipation, the urge to the chair is often absent. The symptom arises against the background of a common heavy state, requiring emergency medical care.
Complications of pharmacotherapy
Most often, constant constipation is due to the abuse of laxatives without the recommendations of the doctor. The uncontrolled reception of these drugs is oppressed by a natural reflex on the intestinal emptying, the relicy muscle fibers cease to react to pulses from the spinal cord. Independent defecation is difficult or impossible. Publishes provoke other drug reasons: the purpose of anticholinergic agents, chemotherapy.
An examination of children who are delayed by a chair, a pediatrician is engaged. If necessary, the children's gastroenterologist attracts for counseling. The specialist collects in detail the history of the disease and reveals the predisposing factors, caustic changes, related diseases. To verify the cause of the constipation, the instrumental inspection of the tract and laboratory methods are prescribed. Most informative:
- Finger study . Assessment of the state of the ampoule of the rectum - the first thing you need to do during the constipation of the child. During the examination, roaming stones, volumetric neoplasms, the places of the greatest pain. Before the inspection, the belly is feeling in order to discover swelling, spasms, an increase in the sizes of the sigmoid intestine.
- Ultrasound procedure . Abdominal ultrasound is a simple non-invasive diagnostic method, which shows signs of inflammatory processes, anomalies of the structure of the digestive tract, suspicious neoplasms. Additionally, using an ultrasonic sensor, a targeted ultrasound of the liver and pancreas is carried out.
- Radiography . The overview radiograph of the abdominal cavity is quite informative, it allows you to detect the expansion of intestinal loops and signs of intestinal obstruction. To verify the state of the colon, irrigography with a barium is assigned, which is carried out after the enema. Sometimes used radiography of the Passage barium on the gastrointestinal tract.
- Coprogram . Microscopic Calate Research includes the definition of undigested food particles, fatty acids, erythrocytes and leukocytes. Bacteriological sowing of caliber masses is required to exclude dysbiosis. The feces are examined on the eggs of helminths and the presence of protozoa infections.
- Laboratory indicators . With permanent constipation, the child performs a biochemical blood test, hepatic tests to eliminate the accompanying hepatobiliary disorders. When suspected endocrine diseases examine the hormonal profile. Sometimes a highly specialized toxicological examination of blood is shown.
- Additional methods . To eliminate organic pathology and intestinal tumors, rectoroscopy or colonoscopy is recommended. For the diagnosis of gyrolshprung disease and the branch during the study, the biopsy of the intestinal wall is taken. If there are signs of violations of the nervous system, you need consultation of the neurologist, EEG and ECUEG.
Help before diagnosis
Short-term (up to 2 days) constipation arising in normal well-being does not require specific treatment. To normalize the stool in infants, it is necessary to add fruit and vegetable puree to the diet, elder children give more fresh or stewed vegetables, useful dairy products. Effectively increase physical activity, which contributes to the intestinal operation and improves motorcy.
During the teaching to the pots, parents are important to abide by patience, do not shout on the child and not forced him to bow. When the latency of the chair is accompanied by changing the color or consistency of the carte masses, common indisposition, pain in the abdomen cavity, this indicates pathological causes. Be sure to consult a doctor who knows how to treat a child's constipation correctly.
Publishers in children in most cases are secondary to the main pathology, so their treatment is aimed at eliminating the root cause. Children with a long-having no chair are prescribed cleaning belizes. With severe diseases, when the defecation continues to linger despite the observance of a special diet, the treatment regimen includes:
- Laxatives . In pediatric practice, soft preparations (lactulose, sensing), which do not have side effects are predominantly used. Lactulose contributes to the growth of the useful intestinal microflora, therefore is recommended for dysbacteriosis.
- Prokinetics . Effective in hypotonic constipation, when there is an insufficient reduction in the smooth muscles of the gastrointestinal tract. Coordinate the work of all departments of the digestive tract, accelerate the promotion of carts.
- Spasmolytiki . In the case of a spastic variant of constipation in children, these drugs are effectively relaxing smooth muscles and facilitate defecation. Preparations also quickly remove painful sensations in the intestines.
- Rectal Candles . Suppositories with glycerin are shown as soft laxatives. They soften the carte masses, make the defective process painless. With strong pains in the anus area, candles with anesthetics are introduced.
In hypotension, electroplating, impulse currents, other stimulating methods are prescribed. In the intestinal hypernone, paraffin applications are shown on the abdomen. To eliminate intestinal hypotension, massage courses with elements of the exercise, which are aimed at accelerating the intestine motorcycles and increasing the processes of neuromuscular transmission. If the chair is missing under the influence of a psychogenic cause, consultation of a children's psychologist is required.
How to help a child when constipation at home: Pediatrician Tips
September 13, 2018.
The constipation is often called a disease of civilization. The symptoms of this deflection are found in people of any age category: in adults, older, children in a year and a half and even in babies. Many believe that children should be treated with children, and costs without medical advice. Is it harmlessly "uncomfortable" disorder and what to do if the baby's pot remains blank for a long time?
From this article you will learn
The normal frequency of the chair in the child is 2-3 years old
Constipation is a type of dysfunction of the gastrointestinal tract, which manifests itself in the form of a systematic incomplete or difficult emptying of the intestine, long-term stool delay. The problem indicates rare trips to the toilet, pain sensations during defecation, the need to spend the shape of the chair. Functional constipation is characterized by regular disorders of the defecation process.
Parents should think about the problem, if the intestinal emptying frequency at the kid has not exceeded three times, when a child is going to the toilet, anxiety is worried. It's time to consult a doctor if the consistency of Kala has become dense, there is blood in it, and the form is a solid cylinder or rounded fragments.How many days your baby does not cake?
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What is the reason
Intestinal disorders can provoke the following factors:
- Using the insufficient number of vegetables and fruits.
- The predominance in the diet of sweet food, protein production of animal origin.
- No or low clean water consumption.
- Rare and irregular meals.
- Dysbacteriosis after intestinal infection.
- Acceptance of drugs, for example, a stool delay may occur after "smects" used in large quantities, as well as after antibiotics, antidiarene, such as Enterol.
- Diseases of the thyroid gland.
- Stressful situations.
Poblugs can cause glisted invasions, as a result of the vital activity of which the process of intoxication arises, weakening the intestinal peristalsis.
In order to protect against infections and poisoning, small children are often given boiled water, in which there are no mineral salts. In particular, potassium lack decreases the intestinal peristalsis. The situation is exacerbated by dry air and heat in the apartment in the heating season causing overheating in the baby. All reasons provoke constipation in a child.
There are also congenital disorders of the intestinal structure, which are usually diagnosed in the first year of the life of the infant. Such deviations in development arise even during the period of fetus embryonic development.
Table 1. Causes of constipation associated with violation of physiology (important! The table can be scrolled to the right and left).
|Name deviations||Description of pathology||As manifest|
|Atresia anus||The underdevelopment of the anus.||It is manifested during the first days in the form of delay of Mekonia, capriciousness, refusal. Development vice is varying degrees of gravity and is in violation of the structure of the rear-ground opening.|
|Congenital narrowing of the intestine||Observed along the entire length of the rectum to the anus.||If the deviation is explicitly expressed, the symptoms resemble signs of atresia. With a small narrowing constipation - a common phenomenon|
|Offset (ectopia) anus||The posterior hole has an atypical location.||There are fistula and chronic constipation.|
|Doubling the rectum||It is characterized by an anomaly at which the intestinal walls have protrusions or quit.||In addition to chronic constipation, the vice can cause intestinal obstruction.|
|Tumor processes||Polyps, cysts and other neoplasms.||Lead to the delay in the chair of varying severity.|
|Girshprung disease||Incorrectly functioning nerve endings on the surface of the rectal walls.||Chronic or clinical constipation.|
Psychological reasons may cause constipation. Once in an unfamiliar situation - a kindergarten, a developing institution, hospital hospital, a kid 2 years old can avoid the act of defecation due to the constraint or unusual plumbing type.
Call the reflex to the delay in the intestinal emptying can inequately teaching a child to the pot, a ban on visiting the toilet educators of a kindergarten (it happens). As a result, the carte masses are gravily compacted, the constipation goes into a chronic form, the reflex is fixed and turns into a stable skill.
Important! The famous Ukrainian Dr. Evgeny Komarovsky among the most common causes of constipation calls the dehydration of the body and the absence of potassium in the diet. In his opinion, 99% of constipation in children are not a state of life-threatening, but require adult interventions, as they complicate the psychophysiological state of the kid.
Factors pointing to constipation is usually difficult to skip careful parents. In case of violations of the act of defecation, the child spends on a pot for a long time or completely avoids a hike to the toilet "in large". The baby shows anxiety, may complain about pain, rice and bloating.
The problem can also indicate the inspection of the pot content. The number of feces in constipation is less than usual, or it is separate particles, its consistency is dense and dry, shape - ribbons or balls. Often when constipation in the wheel masses is visible mucus or blood.
Long-term stool delay causes fermentation and rotting processes. Toxic products have a negative effect on the overall feeling of the kid: it becomes sluggish, bellish, irritable, can refuse food. Often, when constipation, children complain about headache, nausea, sleep disorders. After visiting the toilet, the baby can complain about pain in the back pass.
The absence of a chair in a child during the day is a reason for concern if the child feels an explicit discomfort. The lack of an act of defecation with nausea, vomiting, liquid discharge (diarrhea) through the compacted power facilities - you need to immediately access the doctor.
If the temperature rose - call an intersection. You should contact the pediatrician if nothing helps from home tools.
Normalize the frequency of the chair in a child, as a rule, can be used by the following set of measures:
- Adding to the family diet containing food fibers and potassiums: vegetables, fruits, wholegrain cereals, dried fruits - raisins, kuragi, prunes.
- The elimination of the use of sweets containing artificial sugar, swelling products, products with a high protein, purified white rice.
- The use of pharmaceutical preparations: candles, suspensions, drops, chewing pills.
- Performing a special exercise complex.
- Correction of drinking mode.
- Massage abdomen.
- Application enema.
- Psychological support for non-physiological reasons of constipation.
What if the child has constipation caused by dehydration provoked by infectious or other disease? The main thing is to follow all the recommendations of the pediatrician.
With prolonged violation of the intestinal work, a consultation is needed by a gastroenterologist or an endocrinologist. To identify the causes of pathology, an endoscopic examination may be required, an ultrasound of the abdomen, a laboratory study of blood, urine and feces.
It is interesting. Parents are often asked if there can be constipation in the infant of the banana. The opinion of nutritionists is: the misappropriate bananas can provoke constipation, and overripe fruit, on the contrary, reduce its symptoms.
According to statistics, the most purchased medicines in the world are laxatives.
Medicines for soft and painless intestinal emptying in children are divided into those that are used orally - tea, solutions, pills and rectally - candles, enemas. The effect of oral preparations is based on:
- Mitigating the effect of osmotic drugs. Due to the presence of salts in its composition, such a medicine dilutes cavalous masses. But the main reason for the constipation, such drugs are not eliminated.
- The abilities of laxative medicines to suppress pathogenic microorganisms. Such preparations have therapeutic properties, as they restore the microflora of the gastrointestinal tract.
- An irritant action, rendered by drugs on the intestinal muscles. Artificial muscle contraction enhances the peristaltics and displays the accurate feces. It is impossible to allow frequent use of such funds, as they cause the habit and weakening the activity of the intestine.
In addition to laxatives, medications are prescribed, reduced intestinal tone, probiotics for normal operation of the gastrointestinal tract, enzyme preparations. For permitted means for children for 2-3 years include the following:
- "Forlax". It can be used to treat constipation in children from 6 months. The effect of the drug is based on the holding of water molecules, so that the volume of the contents of the colon increases and is output.
- "Baktisubtil", "Biofirdbacterin", "Bifiform". Probiotic means containing useful bacteria maintaining a long-term healing effect. "Bifidum" is not addictive, the course of treatment can be repeated.
- Duhalak. Hyperosmotic syrup with lactulose.
- "Hilak Forte". Normalizes the composition of intestinal microflora due to the presence of lactic acid and its buffer salts, volatile fatty acids. Diluted with any liquid, excluding milk.
- "Guttalaks". The drug contains a substance of sodium picosulfate, which has an irritating effect on the intestinal receptors. Causes one-time emptying.
- "Trimedat". Tablets, stimulating the activities of the GCT. Cause addictive.
- "Bisakodil". The mucus is produced and stimulate the nerve endings in the intestine.
- Glycerin, vaseline candles and supospory based on sea buckthorn oil. One of the most efficient and secure means, quickly and painlessly empty intestines.
- "Microlax". The drug with an osmotic action capable of bringing relief for 5-15 minutes. Release form - Capacity (Clean) with a liquid containing sodium citrate and sorbitol, with a rounded tip, which is introduced into the rectum. Many pediatricians believe that even adult microclism is better than the usual Mug of Esmark, since this method is fast and safe.
Important! Applying laxatives, you need to accurately comply with the prescribed dosage. Otherwise, they can cause abdominal pain, diarrhea and weakness.
But what medicines recommend Dr. Komarovsky:
Take independent attempts to save the baby from constipation without medical advice undesirable. If a two-year-old child often suffers from constipation, it is quite possible that it is a symptom of any disease.
Cleaning enemas for children under 3 years old are recommended to install only after consulting a pediatrician, since the stool delay can be caused by pathology requiring surgery. With such states, it is impossible to put the enema!
If the doctor gave permission, prepare everything you need: a rubber can, boiled in water according to 30 ml instructions - for oil contents or 250 ml - for an aqueous solution, a pot and alane. The volume of fluid introduced into the rectum depends on the body weight of the child. Oil (sea buckthorn, rich, hemp) or water (chamomile infusion, physical) are heated to the body temperature.
With the baby, it is predefore you need to talk and explain to him the meaning of the procedure. Forcibly to put the enema is not recommended, as physical or psychological injury may occur, especially in the Son. You can tell a fairy tale about microbes that do not want to go out, and about the ass who fell ill and is treated in a similar way.
Before starting the procedure, we need to wash your hands, spread the oilbox, put the baby on the side and ask him to pull the knees to the chest. The tip of the pear needs to be lubricated with vaseline or vegetable oil.
In order to release an excess air from the can, you need to put it vertically and squeeze at the bottom that part of the contents left. Then gently enter the tip in the rear passage and gradually release the contents.
If the child began to cry, the introduction of the enema is better to stop. The baby must lie for a minute ten minutes, then suck him on a pot to shill.
Keep a rag at hand to avoid contamination.
A mug of esmark can only be put up to the baby after 4-5 years.
Important! You can not enter a small child in the back pass baby soap or soap solution. Such practice is a dangerous experience that is fraught with burns and irritation of the mucous membrane.
Folk Medicine has many recipes and recommendations, how to help a child in constipation at home. Practice is common to cure a similar deviation by vegetable oils accepted inside.
In addition to the laxative effect, the means have antiparasitic action, for example:
- Unrefined pumpkin and linseed oil, fish oil. Olive oil, in addition to the sedative effect, contains substances that reduce inflammation.
- Food can also be a medicine. Good grandmother from constipation is boiled beet salad, pumpkin baked in the oven.
- If the child does not like this menu, you can offer him figs or raisins, compote from dried fruit. In general, raisin water or infusion of prunes are universal children's laxatives.
Make them easily: the handful of purified dried fruits is flooded with boiling water and leaves for the night. In the morning there is an empty stomach drinks, and the fruits are eaten. A similar effect is warm water, in which a tea spoon of honey is dissolved.
- A relaxing effect causes fresh prokobivash, kefir, yogurt with the addition of vegetable oil.
- Children who love salty, you can offer sauer cabbage, laminaria.
When a child has constipation, a green pharmacy relief is brought: herbal teas based on fennel, dill, chamomile, raspberry leaves. Slices of flax seeds, dandelion flowers, plantain seeds help from constipation.
Important! Natural - does not mean completely safe. Before giving a baby natural medicine, you need to consult with your doctor.
Diet and prevention
The best prevention of constipation is a healthy lifestyle of a baby, which includes proper nutrition, outdoor walks, physical exertion. According to statistics, even children 2-3 years spend watching cartoons on average two hours a day.
It is not surprising that many of them have problems with the intestines. Gymnastics for such kids, including squats and twisting, slopes should become a daily physical culture minimum.
In 2 years, many kids will stubborn walking on the pot. So that they liked the process, you can choose this subject along with the baby in the store and teach it gradually.
In no case can not be struggling with the baby and scold him if he "guessed", the fear of being punished can lead to a psychological constation. Be sure to ask the child if he goes to the toilet in kindergarten. If there are problems related to psychosomatics, it is desirable to connect to their decision of the psychologist and the educator.
In the diet of the child, vegetable and fruit dishes each day should occupy half from the total volume of food eaten. A child suffering from constipation cannot be given:
- Flour food, rice, beans, legumes, mayonnaise and refined oil.
- It is undesirable to feed roasted and bold.
- Bilberry, quince, persimmon, pomegranate have a fixing action.
The fiber contained in Bran is able to deliver the stool delays if a small child will use them in food daily. Bran is contained in crude cereals: wheat, rice, oatmeal, porridge from which it is advisable to eat constantly. Use the varieties of meat only dietary.
Be sure to comply with the condition so that the baby drinks clean non-gas-free water. In three years, the consumption rate is up to a liter, at five years old - 1.2 liters.
If the baby feels a call for defecation, you must certainly use the toilet and follow the timely empty of the children's intestine.
The combination of all methods is the key to the fact that you and your baby will never know what strong constipation is.
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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.
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.  [four] And if small children are still under control, then adolescents can often be shy to talk about the violation of the chair.  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.
- 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."   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   .
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.   [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.
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.
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.   It makes the child forced to hold back to emptying.
With frequent delays, the sigmoid and direct divisions of the colon are dilated (expand), the susceptibility of the nerve ending decreases   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]  As a result, the fluid flows down the sealing feces and without defecation flows through the hypotonic sphincter (calomase) [one]  .
As the frequency of constipation increases, a disorder of intestinal microbiot is developing, which enhances the pathological state.  [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. 
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. 
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.  [four]
Functional constipation - more than 90% of all cases of constipation. [four]   
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.
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.
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?
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.
- 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.
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.
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.
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.
Baby constipation treatment
- Change of lifestyle, behavior;
- dietary recommendations;
- medication treatment;
- Treatment of herbs;
- 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] 
- 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.  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.
- 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");
- Based on the copron, enzymes ("Creon", Pangrol, Mezim) are prescribed - coursework (two weeks);
- In spastic constipation, antispasmodics are appointed ("Papaverin", "DroTaveberin", "Buckopane", "Duspatalyn"). [one] 
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.
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.
When the constipation will be useful to use mixtures of dried fruits (figs, kuraga, prunes), baked apples, iodine-containing fruits (Kiwi, Feichoa).
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.