How to treat constipation in a child? What to do, what medicine to give?
- Jun 18, 2018
Problems with the intestines in young children and preschool children are not uncommon. Even if the child is troubled by the stomach, he can not always complain to his mother. It is important for parents to notice in time if the baby has not had a chair for a long time or the "great" hike causes him pain, and try to help him get rid of constipation.
Constipation is a consequence of the slow transport of stool masses through the intestines. There are many reasons for this condition, and it can arise at any age. In children, this is the most common disease of the digestive tract, although many parents do not attach much importance to this problem and do not consider it necessary to show the child to the doctor. Moreover, not all mothers know what frequency of trips to the pot is normal for a child of one age or another, and do not pay much attention to the nature of the child's chair.
- 1 What is considered a child's constipation?
- 2 Why do children have constipation?
- 3 Organic Constipation
- 4 Functional Constipation
- 5 Childhood Constipation
- 6 Transient Constipation
- 7 Why is it necessary to treat constipation in a child?
- 8 How to help a child with constipation?
- 9 Treatment of pediatric constipation
- 10 Therapeutic diet
- 11 Day regimen
- 12 Restoration of defecation
- 13 Pharmacological help: what to give a child from constipation?
- 14 Treatment of constipation in children with folk remedies
What is considered a child's constipation?
Beginning at the age of one and a half years old and older, the baby croches 1 to 2 times a day, and his chair is no longer mushy, but decorated. With a tendency to constipation, the intervals between bowel movements lengthen, and the act of emptying itself can cause difficulties. Constipation is also considered a chair with a normal frequency, if it is accompanied by soreness and condensed feces.
Parents should pay attention to such "bells" that signal a violation of bowel function in a child:
- a child under 3 years old goes to the toilet less than 6 times a week;
- at the age of more than 3 years in a child less than 3 defecations per week;
- the child complains of abdominal pain, they show up in babies crying and anxiety;
- the process of defecation is accompanied by soreness, straining, occurs with difficulty;
- stool has an abnormal character: it is separated by small "dry" fragments( sheep's feces) or forms a very dense mass in the form of a thick cylinder;
- there is incomplete emptying.
Systematic occurrence of such symptoms should be the reason for contacting a pediatric doctor. The duration of signs of constipation for more than 3 months already speaks of the chronic course of the disease.
Why do children have constipation?
If you do not identify and do not eliminate the causes of stool delays, constipation can become chronic, and then get rid of them will not be easy. Many adults suffer from constipation for years, which begin in childhood. Seek regular emptying of the intestines with enemas and laxatives is meaningless, if not to get rid of disease-provoking factors.
Among the reasons leading to constipation in children, it is unlikely to include organic ones. In this case infringements of a defecation - consequence or investigation of anomalies of intestines , congenital or got. Congenital pathologies, such as lengthening of the sigmoid colon and lack of innervation of the large intestine, are usually found and cured by the age of 2-3 years, since they are acute and practically from the first days of the child's life.
It is necessary to exclude organic constipation in a preschooler if the absence of an independent chair in his presence arose on the background of normal diet and lifestyle and is accompanied by symptoms of digestive disorders. Inflammation, turbulence, abdominal pain can be caused by the accumulation of stool and gases in the intestines because of the obstacle formed in it. These can be tumors, polyps, spikes of , leading to acute or chronic obstruction. Treatment in this situation, as a rule, is surgical.
In most cases, problems with the intestines in children are functional and psychological .
Functional locks can be the consequence:
- of the child's inefficient nutrition for a long time, with the predominance of protein and fatty foods in his diet and the lack of vegetable fiber;
- chronic fluid deficiency in violation of drinking regimen, when a child drinks a little or receives moisture exclusively from "wrong" drinks( not water, and juices, tea, lemonades, etc.);
- imbalance of the intestinal microflora, which develops against the background of antibacterial therapy and eating disorders and leads to putrefactive processes and weak peristalsis;
- food allergies, as a result of which secreted histamines damage the intestinal wall;
- enzyme deficiency, when due to congenital abnormalities and diseases of the digestive system, this or that food is poorly processed in the intestine;
- helminthiasis, in which helminthic infestations disrupt intestinal function;
- rickets, which is accompanied by a decreased tone of muscle tissue, including those located in the intestinal walls;
- deficiency of iron in the body, because of which the oxygen starvation of the musculature of the intestine develops;
- hypothyroidism, a clinical manifestation of which are constipation;
- disturbances of the reflux reflex due to damage to the nervous system;
- abuse of medicines affecting the digestive tract( enzymes, probiotics, fixing, antacids);
- frequent application of laxatives, enemas, which leads to the disappearance of urge and intestinal addiction to external stimulation, the loss of their ability to independently dispose of stool.
These factors lead to impaired motor function of the intestine: reduce its peristalsis, tone of the walls, damage the mucosa. As a result, the movement of digestive waste slows down and "congestion" is formed.
Psychological constipation in children
Constipation due to psychological reasons is also functional, but is allocated to a separate group because of the difference in approaches to treatment.
The call "great" occurs after the feces, thanks to the motility of the intestine, reach its lower parts and irritate the nerve receptors located there. Unlike toddlers up to a year, in older children the process of defecation occurs consciously and is under the control of the central nervous system. But if the child is in uncomfortable conditions, he can hold back the urge for a long time, preferring to suffer, rather than go to the toilet in an unusual place. The suppression of the reflex to emptying leads to the accumulation of feces, its compaction, which at the time of defecation pours out into the pain and trauma of the anus.
Such problems often occur in children during the period of getting used to a kindergarten, when they get into an unfamiliar place( in a hospital, at a party) and other situations. Constipation may be accompanied by the accustoming to the pot 2-3-year-old babies. Conscious containment of defecation and prolonged disregard for urge sooner or later lead to a "loosening" of the very mechanism of bowel movement, constipation acquires a chronic course. The child can be afraid of croaking even under normal conditions, as reflexively awaits pain.
Each child may experience a "one-time" constipation, when he ate something fixative, fell ill with fever and signs of dehydration or overheated outdoors in the heat. Stool condensation in this case is associated with inaccuracies in the diet and temporary deficiency of fluid in the body, the correction of which in itself leads to the restoration of normal consistency and periodicity of the stool. In such a situation, there is no need to take radical measures to eliminate constipation, it is enough to establish the "right" diet and drinking regimen.
Why is it necessary to treat constipation in a child?
Constipation in a child is not only difficult to go to the toilet. Systematic untimely emptying of the intestine can have a detrimental effect on the digestive system and the entire body as a whole. Chronic constipation to varying degrees can cause the following consequences:
- The disruption of digestion during constipation leads to poor absorption of nutrients, vitamins, microelements, which threatens the development of anemia, weakness, and decreased immunity.
- At the same time, the decay products from accumulated stool mass through the intestinal walls are absorbed into the blood and poisons the body .Signs of intoxication may manifest in lethargy, drowsiness, decreased activity, anorexia, etc.
- Congestion in intestines introduces disharmony into the balance of useful and pathogenic microflora, which can not but affect 's body resistance to diseases of and the digestive process.
- Fecal masses stretch the walls of the intestines, further exacerbating constipation, cause mucositis, spastic pain, increased gas production, violation of the local blood circulation .
- Persistent constipation results in rectal cracks, bleeding from the anus, soreness. The child is afraid to go to the toilet, his develops the neurological problems of .
How to help a child with constipation?
If all attempts at pokaking end in vain, the task of parents is to alleviate the child's condition, help him cope with constipation. Although preschoolers are allowed many laxatives, parents should try to not to resort to them without prescribing a doctor .
As a first aid to the child, glycerin suppositories and cleansing enema are quite suitable. Rectal suppositories with glycerin are even put on the newborn, they are safe and effective.
In the absence of candles, you can make an enema from a glass of boiled cool water. In the water for enema, it is recommended to add 1-2 small spoons of glycerin. Sometimes it is recommended to do an enema from saline, but it can cause burning and pain.
When setting up an enema, you need to follow security measures.
- The pear should be disinfected and oiled with oil or baby cream.
- Water can only be used cold, not warmer than room temperature, otherwise it will suck in the intestines, carrying with it toxic products that stand out stagnant feces.
- You can not pour a lot of fluids into the rectum, as you can injure or stretch it, cause pain and sharp spasms.
These measures should be sufficient to obtain a lenient action at home, after which the child should be called by a doctor or taken to a pediatrician at a polyclinic. Do not often resort to such funds, since this is not a cure, but a temporary elimination of the symptoms of a difficult bowel movement.
Immediately need to see a doctor without trying to make an enema if the child:
- has severe abdominal pain, gurgling, symptoms of intoxication;
- blood from the anal opening;
- involuntary calming, when the liquid stool seeps out against the background of persistent constipation.
Treatment of pediatric constipation
If a child is disturbed by constipation, parents should not ignore this fact and try to cope with the problem on their own. The pediatrician who will prescribe tests( blood, urine, coprogram, feces for helminths) should address this issue and send the child to the necessary specialists: surgeon, gastroenterologist, endocrinologist, neurologist, etc.
A set of therapeutic measures should be aimed at achieving regular and natural cleaning of the baby's bowels( daily or at least every other day), preferably at the same time. Defecation of the toddler must pass without tension, with calves of normal density and consistency.
Treatment of constipation in a child is an individual case that takes into account all the factors that exist: the severity of the disease, its causes, the presence of pain, age and psychological characteristics of the baby, concomitant diseases. Parents need to be prepared, that treatment will last not one month. Complete recovery of bowel functions and the elimination of related psychological problems of the child can take up to 2 years.
As a rule, the first exercise for constipation is prescribed a laxative diet. This is one of the most important links, without which the struggle with constipation is impossible. However, it is not so easy to organize a therapeutic diet for a child. Most often, doctors ask parents to change the eating habits of the whole family - so it will be easier for a child to endure "deprivation" and adapt to a new diet.
- Give up food that provokes a thickening of the stool. This baking, rice porridge, pasta, whole milk, from fruits - bananas and unclean apples.
- Exclude gassing products: cabbage, legumes, mushrooms, tomatoes.
- Do not eat foods that reduce intestinal motility. This is tannin and caffeine-containing products( tea, coffee, cocoa, chocolate, blueberries), enveloping soups and cereals, jelly.
- For rapid transport of fecal masses through the intestine, they must be formed in sufficient quantities. For this, the menu consists of dishes containing coarse fibers. These are vegetables, fruits, cereals. It is useful to add bran in food, there is whole wheat bread. The amount of fiber recommended for consumption by children over 2 years is calculated from the child's age: it is equal to the number of full years of the baby plus 10 grams from the top.
- The rest of the diet is supplemented by "neutral" products: lean meat, chicken eggs, oils.
- The child should drink a lot, at the heart of the drinking regime - pure unboiled water( filtered, bottled) without gases, without additives.
- Necessary to eat a sufficient amount of sour-milk products. This yogurt without additives, yogurt, yogurt, bifidonaditki.
- If the child is diagnosed with inflammation in the intestines, he is transferred to strict adherence to the diet - table number 3 or number 4 for children.
Day regimen of
The of stable day regimen organization is of great importance in the treatment of pediatric constipation. It is necessary that meals, hiking, etc.always occurred at a certain time. So the child will develop a habit of emptying the intestines daily at about the same time, preferably in the morning. At the same time, he will be ready for the act of defecation both psychologically and physiologically.
Also parents should instill the child's habit of starting the morning with one glass of cool water and charging. If, after drinking water, a urge to the toilet does not occur, the child needs to warm up, have breakfast and try again to poke again.
Physical activity should be manifested during the day. Gymnastics promotes the activation of intestinal motility and the promotion of food leftovers through the digestive tract. Especially useful exercises:
- machi straight and bent legs;
- bringing knees to the abdomen;
- exercises for the press.
Ice skating, cycling, running, outdoor games - any movements use the front abdominal wall and cause intestinal muscles to work. Little children can be offered to work out in a game form: scatter beads on the floor and collect them, fully unbending, lifting each of them, etc.
Restoration of defecation
In case of problems with constipation, it is necessary to teach the child, however strange it may sound, to properly croak.
- It is necessary to explain to the baby that the doctor will soon cure his ass, so going to the toilet will not hurt. Even if it's unpleasant now, you still have to try and kick at the same time.
- A child needs to create comfortable conditions. If he goes to the pot, then buy a handy pot, watch out so that it is not cold. Leave the child alone in the toilet or morally support it - every parent knows his child better. The main thing is not to scold him under any circumstances and to praise him on success.
- The most effective pose for emptying is squatting, legs are pressed to the stomach. If sitting, then put a bench under your feet. You can massage your belly with your hands. To help the process of defecation, a child can, if he quickly draws and relaxes the anus or pushes his finger at the point between the anus and the coccyx.
Pharmacological help: what to give the child from constipation?
If necessary, the doctor will prescribe treatment with laxatives. Since laxatives can cause addiction, as well as side effects in the form of allergies, medicinal diarrhea and other troubles, they should not be used in children for more than 2 weeks.
Children under 3 years are allowed laxatives based on lactulose, for example, Dufalac and its analogs. This is a safe drug, prescribed even for pregnant women to increase the volume of feces and soft stimulation of intestinal peristalsis. Duphalac dosage is increased gradually, starting with 5 ml of syrup, and then gradually reduced.
To eliminate sluggish work of the intestine and relieve spasms, two groups of drugs are called: prokinetics and antispasmodics .The first significantly activate the digestive tract, beginning with the expulsion of food from the stomach and ending with the toning of the entire intestine. One of these drugs - Domperidone, normalizes the stool, relieves pain in the abdomen and eliminates gases. Children are prescribed before meals for 0.5-1 tablets 3 times a day for a month. Babies are given a medicine in the form of a liquid.
For violations of the intestine, expressed in spasms( the so-called irritable bowel syndrome), children are prescribed spasmolytics - No-shpu, Papaverin, belladonna in candles for one to one and a half weeks.
Children with a constipation for constipation are also shown vegetative choleretic preparations, such as Hofitol. Their task - to fill the deficiency of digestive juices, stimulating the production of bile and pancreatic secretions. This allows the child to better assimilate food and quickly withdraw its unprocessed residues from the body.
Preparations containing bifidobacteria and lactobacilli are recommended for all children with constipation for the treatment of dysbacteriosis, restoration of healthy intestinal flora. These include Lineks, Bifidumbacterin, Hilak Forte and others.
Treatment of constipation in children with folk remedies
It is possible to help the body of a child to cope with constipation and to establish a normal defecation with the help of folk methods.
- Natural laxatives are wheat bran and sea kale. They can be added to food or taken directly from a spoon, with plenty of water. In the intestine they swell from the water, increase the volume of feces and dilute them, facilitating effective excretion. The dosage of bran is 15 to 50 g per day, the laminaria powder is 1-2 tsp.
- Infusion of senna leaves( 1 tablespoon per glass of water), brewed in the evening, drain in the morning, give the baby 1 spoon up to 3 times a day. Has a laxative effect, without causing cramps in the abdomen.
- Rub the leaves of the dog rose with sugar or squeeze the juice from the flowers into the spring water, give the baby several times a day.
There are dozens, if not hundreds, of people's laxative recipes. But do not forget that not all natural medicines are suitable for children. It is unlikely that the child will agree to drink a bitter, astringent, fresh juice of onions or potatoes. He can give up the infusion that needs to be taken in glasses.
When choosing a prescription for a child, one should look for one that acts gently, painlessly, and it will not be disgusting to take it. Universal means that are popular with all children are dried fruits ( prunes, dried apricots) and decoctions of them( raisins).Here are a few recipes that normalize the emptying, which are applicable in the situation of constipation in children:
- grind the peas into powder, give the child every day a teaspoonful;
- take 3-4 times a day oatmeal jelly or a rich broth of plums;
- babies who love salty, you can give brine cabbage;
- brew tea from dried cherries or apples;
- 3 times a day to eat a "dessert" from a mixture of honey and aloe juice( 100 g of one and the other to insist at least 3 hours, take 1 spoon before eating for an hour).
All these measures are something that every parent can do. If a child develops psychogenic constipation, which, despite the symptomatic treatment, continues to pester the baby, do not neglect the advice of a psychologist. Perhaps, the expert will be able to identify the true causes of situational constipation and help with the solution of this problem.