Contents
Children of all ages are at risk of developing constipation. In the first months of life, bowel problems can cause maternal malnutrition or incorrect initiation of complementary foods. Children 2-3 years old have a fear of the potty, older children have stress in kindergarten or school.
– The prevalence of constipation among children in the world, including infants and adolescents – from 10 to 23%. Every fourth child (1) encounters this problem to a greater or lesser extent, says pediatrician, head of the children’s clinic of the Maternity Hospital No. 4 at the GKB named after. V.V. Vinogradova Vladislav Zyablitsky.
Causes of constipation in a child
Constipation in a child is mainly associated with gastrointestinal problems, but may be a manifestation of other diseases, such as hypothyroidism.
In the process of digestion, the walls of the intestines contract in waves and push food to the exit opening – this function of the intestines is called peristalsis or motility. If it is violated, atonic (decrease in the tone of the intestinal wall) or spastic (with intestinal spasms) constipation can develop.
Consider the most common causes of constipation in children.
1. Violation or change in diet
This is the most common cause of constipation. Changing the diet, switching from breastfeeding to artificial, lack of fiber in the diet, a large amount of animal products (meat, dairy products) lead to stool retention. Violation of the diet leads to the formation of dense fecal masses that stretch the walls of the lower intestines. As a result, the urge to defecate becomes weak, which can lead to chronic constipation.
2. Inadequate fluid intake
Lack of fluid in the body is another reason for the development of constipation. Dehydration can develop due to loss of fluid, for example, during vomiting or diarrhea, insufficient fluid intake, excessive sweating at a high temperature in a child.
3. Taking certain medications
Some medicines can cause constipation in a child. If you suspect that constipation was caused by taking medication, you should inform your doctor. He will replace the prescribed drug with another one. Antibacterial drugs can disrupt the normal intestinal flora and cause dysbacteriosis (2) which can also lead to constipation. In this case, it is necessary to prescribe probiotics (drugs containing intestinal bacteria).
“Constipation can be an adverse reaction to certain medications, such as iron supplements, which a doctor may recommend to a child to treat anemia and prevent it,” the doctor adds.
4. Psychological factors
Quite often, the cause of constipation in children are psychological factors, such as, for example, potty training, attending kindergarten or school.
Early potty training, not getting up from it, and other related factors can disrupt the functioning of the intestinal tract. A child who is not toilet ready may not understand the connection to the urge to defecate and urinate and the potty. This can cause dislike for the process and the desire to restrain the urge to defecate. Therefore, doctors do not recommend potty training a child ahead of time.
The change of scenery associated with attending a kindergarten or school, the environment of peers do not allow the child to feel free, which forces him to restrain the urge to defecate. This leads to the accumulation of feces in the lower intestines and reduces the sensitivity of the rectum. The child ceases to notice the urge to defecate and constipation becomes chronic.
Another reason for holding back urges may be the fear of going to the toilet because of a painful bowel movement.
– Going to the toilet with constipation may be accompanied by the release of scarlet blood, because due to strong stress, microtraumas and anal fissures appear in the child. Periodically, abdominal pain may occur. In young children, this can form a pathological habit of avoiding going to the toilet. Some children squat down to prevent a bowel movement, which only exacerbates the problem, explains pediatrician Vladislav Zyablitsky.
5. Bowel obstruction
This condition can develop in a child due to anomalies in the development of the intestine, the presence of a foreign body in the stomach or intestines, as well as the wrong transition from breastfeeding to artificial. These factors contribute to the violation of peristalsis, which leads to the accumulation of feces and stretching of the intestinal walls. If the child did not have bowel action for 1-2 days, gases do not go away, the temperature rises, you should immediately consult a doctor. Acute bowel obstruction may require emergency surgery.
Symptoms of constipation in a child
The child may not notice problems with the stool or be embarrassed to talk about them, but parents can guess the situation themselves if they pay attention to the symptoms characteristic of childhood constipation:
- reduced stool frequency (normally three times a week) (3);
- a change in the consistency of the stool (separate hard balls, but there should be a smooth “sausage”);
- strong tension in the process of defecation;
- blood in the stool;
- fecal stains on underwear;
- stomach ache.
It is worth noting that stool retention is not always a cause for concern. So, in babies, stools can be absent from three to five days. Doctors call this condition dyschesia. In this case, the difficulty in defecation is caused by the fact that the baby still does not know how to coordinately strain some muscles and relax others in order to “go big”.
Treatment of constipation in a child
With constipation in a child, first of all, you need to contact a pediatrician or pediatric gastroenterologist. Self-medication, any folk remedies are contraindicated, because they can only worsen the situation.
Medical supplies
Self-administration of laxatives to a child is not recommended. They can cause increased gas formation in the child.
– For constipation, the doctor may recommend ready-made microclysters with hypertonic saline or glycerin suppositories, it is also safe to take lactulose by mouth at any age (4). But you should definitely consult with a specialized specialist – a pediatrician or a gastroenterologist, – the doctor clarifies. Vladislav Zyablitsky.
What can be done at home
Is it possible to give an enema to a child with constipation? Frequent use of enemas can inhibit the natural urge to defecate. This tool can be used occasionally, following all the necessary recommendations.
The volume of enema in a newborn child up to 1 month. should be no more than 30 ml, in a child up to 3 months. up to 40 ml, 3-6 months. -90 ml, 6-12 ml – 120 ml. The water in the enema should not be warm, but at room temperature (22-24 ° C). In warm water, the toxins accumulated in the intestines are dissolved and then absorbed into the blood. Enemas of large sizes should only be given by a doctor, as this can cause serious complications.
To improve peristalsis at home, the child can be given a glass of water or juice.
With psychogenic constipation, it is important:
- Improve the child’s diet, give more vegetables, various drinks. This will provide a soft stool;
- It is important to support the child. Do not exacerbate the problem and do not draw the attention of the child to it. No need to constantly ask the child if he wants to go to the toilet? If he is shy or afraid, he will definitely answer “no”;
- Play role-playing games with your child – this is a good way to solve psychological problems in a child;
- Do not scold the child or show that you are upset. Behave positively;
- Give the child useful information about the structure of the body, about the processes that occur in the body;
- Tell thematic tales, invent them yourself;
- Warn caregivers of the problem. Do not insist that the child must go to the toilet in the kindergarten or school.
Diet for constipation in a child
Diet for constipation is just as important as the treatment itself. Proper nutrition will not only prevent the development of constipation, but also improve the well-being of the child.
When compiling a diet, it is necessary to take into account age and related nutritional characteristics. You should give your child foods that improve bowel function, and not give food that slows down motility. It is important to observe the drinking regimen, give the child a sufficient amount of liquid, and this is at least 2-3 glasses of water, fruit drink, compote (5).
It is necessary to control the composition of the diet, the calorie content of food, the content of vitamins and minerals.
What can not be given to a child with constipation? With constipation, restrictions apply both to the child and, in the case of feeding, to the nursing mother. From the menu it is necessary to exclude:
- strong tea and coffee;
- milk;
- semolina;
- sweet pastries, white bread and pasta;
- fatty food.
Expert Opinion
Vladislav Zyablitsky, head of the children’s clinic of the Maternity Hospital No. 4 at the GKB named after. V.V. Vinogradov.
Constipation is a common complaint among parents of young patients. It is good when this problem is noticed in time, before the child develops pathological behavior. In the worst case, neglected constipation can lead to impaired physical development. Children with a similar problem begin to eat less food and refuse to play sports, as this causes them pain. In addition to adynamia (a sedentary lifestyle), constipation is fraught with injuries to internal organs, intestines and rectum.
To prevent this, you need to remember the basic rules for the prevention of constipation: eat a balanced diet, see a doctor, and lead an active lifestyle. Parents should teach their child proper toilet skills and supervise them.
Planting a child on the potty should be at the same time, even if he does not have the urge. Morning hours, such as after breakfast, are best suited for this. At the same time, the pot should be comfortable and warm so that the baby does not experience negative emotions from the process (6).
Sources of
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