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Snaps
Constipation - a problem that can occur at any age: newborn
baby, a preschooler, student or young person. It is believed that constipation -
the most common pathology of the gastrointestinal tract in children.
Constipation - this is difficulty in the act of defecation (bowel movements -
the process of bowel movement) or the absence of independent bowel movement
within what - that period of time. Depending on the child's age periods during
which should be an independent chair, changing. Newborn baby, who is to
breastfeeding, "has the right" to a number of bowel movements, how many times it
is fed. This - an ideal option, but for today's children under age 2 - 3 months
is acceptable to have a chair for at least 2 times a day. For children in
artificial feeding, before the year is the lack of self-locking chair during the
day.
For children under 6 months of constipation is not only the absence of
independent bowel movement during the day, but the appearance of solid drawn
feces. The normal stool consistency in this age is considered a "mush" that is
unformed (but not liquid) cal. If a child who is under six months, feces - in
the form of "sausage" or "balls" - a tendency to constipation. At the age of 6
months to 1.5 years of feces can be as mushy and presentation.
In children of preschool and school-age constipation - lack of an independent
chair during the day. Thus, consistency of stool may not be solid.
Often a child is absent defecation more days, maybe even 2 - 3 days, and then
the child goes to the toilet "gruel" or liquid, but it's like - constipation.
If a child is alone, ie without adult assistance, empties the bowels once or
several times per day, but much tuzhitsya, crying, and calories - very solid in
the form of "nuts" (the so-called "sheep feces), small portions, often with
streaks of blood - this is also constipation.
The presence of constipation in older students, parents can figure out if the
child goes to the toilet with a book, and long leaves. In this case, you need to
talk to him, because adolescents are often ashamed to tell parents about their
problems with a chair.
For some people (according to different sources from 3 to 10%) is normal bowel
movements once every 2 - 3 days. In this case, they - uncomplicated act of
defecation, consistency of normal feces, and the delay of the chair does not
cause any unpleasant subjective sensations (such as lethargy, feeling of
heaviness or overflow in the abdominal cavity, abdominal pain, loss of
appetite). Usually, such features are hereditary. If your child belongs to a
group of people, this rhythm of bowel movements is usually set to 7 - 10 years,
but until then he should go "to - big, like other children: at least once a day.
What are constipation
Constipation can be caused by congenital anatomical defects of the colon and
rectum (congenital аганглиоз - Hirschsprung's disease, achalasia of the rectum,
etc.). Most of these states manifest lack of bowel movements since birth. There
may also be acquired anatomic bars: after surgical interventions in the rectal
area or in the abdominal cavity due to adhesive disease. Constipation anatomical
nature are called organic. These locks are engaged children's surgeons, in some
cases have to do emergency surgery.
In most cases, children do not meet organic and functional constipation.
Functional constipation caused not by structural lesions in the intestine (all
formed correctly, no guts no anatomical defects), and violations of regulatory
mechanisms of gastrointestinal motor activity - the intestinal tract
(gastrointestinal dysfunction).
As a result of various reasons, which will be discussed below, the changing tone
of the intestinal wall. Constipation can be spastic, when a tone - the plot
intestine increased, and stool can not overcome this place. Externally this is
manifested in the form of very dense, "sheep" stool. Another kind of functional
constipation - hypotonic, or atonic constipation. In this case, the delay
defecation may reach 5 - 7 days, feces can be a large volume, leaky.
The causes of functional constipation
In infants an important factor for the normal functioning of the intestine is
food. Usually children in artificial feeding, chair twice less than babies who
receive breast milk. It must be remembered that the young child has not yet
established mechanisms of regulation of digestion and adaptation capabilities.
Therefore, any change in supply can lead to bowel dysfunction, one manifestation
of which is constipation. It is desirable that the baby at least 6 months, fed
breast milk, it is undesirable introduction of complementary foods (juices,
purees, cereals, dairy products, cheese) to 5 - 6 months, it is undesirable
frequent changes in nutrition, particularly the base (if the child gets what -
is an artificial mixture , do not try to replace it for another, if there is a
clear need to).
Dysbacteriosis intestine is often accompanied by constipation. Violations of the
normal intestinal flora occur for different reasons. Any problems during
pregnancy, such as risk of miscarriage, toxemia, infectious diseases,
antibiotics or hormones, latent, lingering illness in pregnant women can cause
the development of dysbacteriosis child. Other causes are: cesarean section,
prematurity, infection of the child and improper feeding (early transfer to the
artificial mixture, delayed introduction of complementary foods, lack of
stability of supply).
Nutrition, as a regulator of motor function of the intestine, retains its role
and the older children. By the appearance of constipation can cause long term
use of mechanically and thermally gentle food (pureed dishes, mashed potatoes,
kissels, oatmeal - a sap, etc.), lack of foods containing crude fiber or dietary
fiber. The use of high calorie, low volume of food (caviar, chocolate, flour
products) may also contribute to the emergence of constipation. There are
products that have perpetuate action. This is - strong coffee and tea, cocoa,
cheese, rice, pomegranates, pears, quince, knitting products, and the
above-mentioned chocolate, flour.
Following important factors for the development of constipation are muscular
hypotonia (muscle weakness) and lack of exercise (sedentary lifestyle). Infants
muscle weakness may develop on the background of malnutrition (underweight
children) or rickets. Muscular hypotonia at an older age is a consequence of
hypodynamia.
Important role in shaping a child's functional constipation plays a
psycho-emotional stress. Any trauma can lead to the development of a child
resistant lock. This may be the death of loved ones or pets, overly severe
punishment for the infraction, a strong fear, conflicts with peers, failure in
school, etc. We often start school constipation due to the need willpower to
suppress the urge for defecation because of fears beg off with a lesson or shy
to go to the toilet "for - the big" school.
Constipation can lead to uncontrolled use of certain drugs (smectic, Imodium,
Bifidumbacterin, enzymatic preparations). Frequent use of enemas and laxatives
oppresses its own reflex bowel movements.
Finally, constipation is often accompanied by other diseases: endocrinopathy
(diabetes, hypothyroidism, etc.), psychological and neurological disorders
(depression, multiple sclerosis, meningitis, etc.), cystic fibrosis, myasthenia
gravis, stomach ulcer, etc. Constipation in these severe illnesses is one of the
symptoms to the fore yet published clinical picture of the underlying disease.
In diseases of the rectum (fissures, hemorrhoids) is often formed functional
constipation.
Often constipation is accompanied by a parasitic infestation (worms), and
constipation can be practically the only symptom.
Prevention and correction of constipation
Given the importance of proper nutrition and lifestyle largely depends on the
parents' normal functioning of the gastrointestinal tract of the child and, as a
consequence, the presence or absence of his constipation.
To prevent constipation in infants toddler parents should try to adhere to the
following principles of good child nutrition:
• as long as possible to preserve the natural feeding with breast milk. Exposed
to the bacteria breast milk is not a contraindication to breastfeeding, as is
almost always possible to treat the mother, not stopping breastfeeding;
• possible to stabilize the child's diet before 6 months. For baby food, any
change involves risk of failure of adaptation, so often the problem child's
chair are compounded when the parents begin to feverishly to change from one
blend to another. This applies to the treatment mixtures are not always
appropriate to impose up to six months;
• do not need to introduce solid foods until 5 - 6 months. Tiny enough for the
normal development of the nutrients contained in breast milk or adapted mixtures
- breast milk substitutes. The premature introduction of complementary foods can
cause a child's constipation and other problems of the gastrointestinal tract.
The only exception in the child's tendency to constipation can be the
introduction of banana and (or) prunes (broth, juice, puree) or fruit
(vegetable) puree, but not earlier than 4 - 4.5 months;
• Any new product should be introduced gradually, starting with small quantities
(as is the gradual introduction of a new product, the lower the risk of bowel
dysfunction). No need to introduce multiple new products. Time to adapt to the
new product is greater, the younger boy, and is, on average, 7 - 10 days, during
which you can enter only one new product.
For infants as prevention and correction of constipation is very important to
drink. Liquid is a "filler" until the intestine until the child receives a solid
food that contains fiber and dietary fiber. In the child drink limit does not
need to (let's "how many drinks"), at the same time do not need to try to
forcibly inject the liquid into the baby. As the drink may be used: boiled water
(sweetened with sugar or fruit sugar), children's tea with fennel, chamomile,
dill water, with 3 - 4 months - dilute broths from prunes, dried apricots, dried
fruit (1:5 relative to the normal compote) , berry fruit drinks (10 berries in a
glass of water).
Children up to 6 months still poorly developed reflex bowel movements, which
manifested a tendency to constipation. In this case the baby to help stimulate
the conditioned reflex of defecation. This is done as follows: shortly before
each feeding a light massage (5 - 7 minutes), which includes rubbing the abdomen
in a clockwise direction, podgibanie legs to his stomach, reupload on his
stomach. After the baby ate, you can tickle him in the anus, which is the
stimulation reflexogenic zone. If an independent chair, the child has about a
day, it is desirable in the same time consistently engage in activities that
stimulate the reflex of defecation, passing to the form of action, if the
previous did not lead to bowel movement:
Massage, described above, but more intense and long (20 -30 minutes);
Mechanical stimulation of the anus in the form of translational motion
netravmiruyuschimi objects necessarily with petroleum jelly or cream (myltse,
stick with a cotton swab, the end of a rubber bulb, etc.);
Send vapor tube (eg rubber bag with the top cut off) for 10 - 20 minutes, with
the bend legs to his stomach. However, gases can be a chair.
Only in case of failure of all these activities and no more frequently than once
every 36 hours can make a child a cleansing enema with water at room
temperature.
Children with a tendency to constipation shows a bracing massage. Especially
important is the massage for impaired children (preterm, intrauterine people
receiving antibiotic treatment, children with neurological disorders or
dysfunction, children with rickets). These children are often muscular hypotonia
and delayed formation of the reflexes, which can lead to constipation. Massage
strengthens the muscles of the abdominal wall and accelerate the formation of
reflexes.
After the introduction of the diet of the child solid food for the prevention of
constipation is essential that the child receives products containing cellulose
(vegetable origin), and dietary fiber (bread, neprotertoe meat, nuts). Food
should not be mechanically and thermally gentle, on the contrary, it is
desirable that the child ate raw vegetables and fruits, salads, vinaigrettes,
crisp cereal, vegetable soups, meat dishes and poultry better piece.
Great importance for the prevention of constipation are the correct treatment
and a favorable psychological atmosphere. Must be rational alternation of work
and leisure, avoidance of excessive loads. It is important that the child has
enough motor activity, we should not allow situations where a son or daughter
sat for hours watching television or computer. Do not be too harsh to punish
children for the faults, check to see that the punishment had been appropriately
misdemeanor to avoid the psychological trauma of the child. Also important that
parents had confidence contact with the child in time to learn about his
problems and try to jointly solve them.
If, however, the child appeared constipated, extremely undesirable to use
laxatives. In addition to the oppression of its own reflection in the bowel
movements, it is fraught with violations of the absorption, the development
dysbacteriosis and inflammation in the intestine.
If constipation should try to restore the normal functioning of the intestine
due to feeding. Products that have slabyaschim action: raw vegetables, fruits,
melons (watermelon, melon), sea kale, stone-fruit (plum, cherry, apricot),
banana, milk products (kefir, yogurt, cheese), crisp cereal (oatmeal, buckwheat
, corn, barley), bread from coarse flour (rye bread with bran), vegetable oil.
You can give preference to these products, while reducing the consumption of
products with the action of fastening (cottage cheese, tea, coffee, cocoa, rice,
chocolate, flour).
Perhaps the use of contrast of temperatures: for one meal a child receives food,
different in temperature, for example, eat a hot meal and then drinks a glass of
cold liquid (juice, mineral water, juice).
It is also necessary to normalize the motor mode of the Child, in particular, to
conduct exercises aimed at strengthening the abdominals. Are useful hiking,
jogging, cycling, skiing and skating, swimming.
If parents can not cope with constipation in a child above listed methods, then
it is necessary to give a stool in the bowel bacteria overgrowth and seek
medical advice - gastroenterologist.
Treatment of functional constipation in children - a difficult matter, very
often requires a fairly long time. The less there is dysfunction, the easier it
is to treat her, so if your child has constipation or a tendency to
constipation, there are more months should not postpone visits to the doctor.
By
Dr. Andrey L.Sokolov,
Dr. Yury A.Kopoanev
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