Constipation is a symptom of many diseases. It is manifested as: long time no bowel movement, too hard stools, too difficult to discharge, or some special symptoms, such as: abdominal pain, long-term hard defecation, rectal distension, Feeling of incomplete defecation, and even need to use maneuvers to help defecate. In the case of not using diarrhea, spontaneous emptying of feces no more than 2 times within 7 days or long-term unconsciousness.
Newborns usually pass meconium within 24 hours after birth. If it exceeds 36 hours, the delay in passing meconium is called neonatal constipation. The interval between normal bowel movements generally does not exceed 48 hours, but some children usually have a soft stool in 2 to 3 days, which is often a physiological phenomenon. Therefore, it is more reasonable to judge based on the nature of stool than the time between defecation.
1. So how does constipation occur: The rectum is empty most of the time. When the stool in the colon reaches a certain amount, it enters the rectum. The rectum is expanded by the stool, which stimulates the baroreceptors of the rectum and transmits information to the cerebral cortex. , Produce defecation intention, the cerebral cortex defecation instruction is transmitted to the effector organs involved in defecation through the efferent nerve, so the rectum contracts, the anal sphincter relaxes, the diaphragm and abdominal muscles contract, the abdominal pressure increases, and the stool is discharged from the body. This is a normal defecation process. .
If certain factors cause the rectal wall baroreceptors to be insensitive, the rectum and anal sphincter muscles are dysfunctional, the intestinal peristalsis function is weakened, the stool cannot be discharged in time, and the water is excessively absorbed, so the stool will dry up and cause constipation.
2. What factors can cause constipation
(1) Improper diet
Some children eat too little food. After the food is digested and absorbed by the gastrointestinal tract, there are few food residues left, which can not form much pressure in the colon, so they will not have the intention of defecation. Some children eat too much meat and too little vegetables and fruits, so the food contains more protein and less fiber. There are many protein components, stools are alkaline and easy to dry; the plant cellulose content is too small, the colon content is small, the intestinal tract lacks stimulation, and it is not easy to produce bowel movements. Some children like to eat dry food and drink less water. After the intestinal tract absorbs water, the feces will dry up, and the intestinal irritation will be insufficient, and constipation may also occur. Milk contains a lot of casein, calcium salt is also high, intestinal stimulation is insufficient, and children are also prone to constipation.
(2) Poor bowel habits
Some children are addicted to play and delay defecation, their lives are irregular, their diet is irregular, and their bowel movements are too random. They cannot form a conditioned reflex to defecate, which is also a common cause of constipation.
(3) Children with rickets, malnutrition, and hypothyroidism have poor abdominal muscle tone, or weakened bowel movements, and constipation is more common.
Anal fissure; inflammation around the anus, pain in the anal orifice when defecate, and children who are afraid of pain can not understand the bowel movement, leading to constipation.
Children with Hirschsprung's disease have constipation, abdominal distension and vomiting soon after birth.
When abdominal tumors compress the intestinal cavity, stool cannot pass smoothly, and it can also cause constipation.
(4) Neurological factors
Brain dysplasia, microcephaly, head injury and other brain diseases are not easy to cause constipation.
(5) Lack of vitamin B1 leads to weakened bowel motility and constipation
4. The adverse consequences of long-term constipation in children
If children often have constipation or dry stools, it will affect the child's health, can cause anal fissure or hemorrhoids, and can also affect the child's digestive function and reduce appetite. If this situation continues, it will gradually cause the child's malnutrition and affect normal growth and development. In addition, many cases of constipation in children are caused by diet, eating high-precision foods. During the processing of these high-precision foods, a large amount of vitamins and minerals are lost and destroyed, and the digestive system lacks crude fiber for a long time. Function, slow bowel movement, so that the digestive function declines, so the child's digestive system may become dysfunctional over time.
5. Prevention of constipation
(1) Improve diet
Increasing fiber content is especially important for children who are partial eclipses, picky eaters, and refined rice noodles. These children eat more meals made of celery, cabbage, fruits, corn, sorghum, and sweet potatoes, which can prevent constipation.
If a child who eats milk is constipated, put more sugar in the milk, for example, adding 8%, sugar can soften the stool. Adding complementary foods in time can also relieve infant constipation. Children with constipation can usually eat honey, tomato juice, fruit juice, vegetable soup, because these foods have a smooth intestinal effect.
Children with malnutrition should try to improve their appetite, gradually increase nutrition, and improve the nutritional status of the whole body. The strength of the abdominal muscles and intestinal wall muscles is strengthened to have the power to discharge stool.
(2) Develop regular bowel habits
Many children have constipation caused by irregular defecation, and their defecation reflex sensitivity is reduced. If you can develop good bowel habits, the constipation of these children can be relieved. Because eating can promote gastrointestinal reflex, it is best to schedule bowel movements after meals. At this time, let the child sit in a basin or go to the toilet to gradually develop defecation conditioned reflex.
(3) If the child has very dry stools and is really unable to defecate, use Kaisailu or glycerin suppository to laxate, because glycerin has a stimulating effect on the intestinal wall and can cause reflex defecation. Glycerin itself also has a smooth intestinal effect. If you still can't pass stool, you can wear gloves to expand the anus, but this method of defecation is only an emergency measure and cannot be used frequently.
(4) Timely treatment of colon and anal diseases
If children suffer from anal fissures and perianal abscesses, they will be afraid of defecation and delay defecation. The longer the delay, the harder the stool will be, forming a vicious circle. Therefore, the primary disease should be treated promptly.
(5) For constipation caused by neurological diseases, in addition to the treatment methods described above, the primary disease must be treated.
6 The main treatment measures for constipation in children
First, acute constipation. Acute constipation in childhood is mostly a self-limiting condition, which can be induced by many factors, such as systemic diseases, dietary changes, and travel. Another situation is that the baby is well fed, has gained weight, and has no bloating, abdominal cramps, etc., and should continue to be observed. However, if you are overly irritable, poorly fed, or have obvious abdominal distension, you should be treated immediately. A small glycerin suppository can be inserted into the anus or enema, and repeated finger irritation in the rectum should be avoided. Older children can be taken orally with magnesium oxide emulsion or appropriate laxatives.
Second, for the chronic constipation of toddlers and older children, a successful treatment plan is to explain the pathophysiological mechanism of constipation to the child, the child’s parents, teachers and other caregivers at the beginning, so that They recognized that constipation is the result of chronic stool retention, rectal dilation, and reduced sensory feedback, rather than simply because children lack sensory feedback for bowel movements. A successful treatment often takes several months to complete. During the treatment, adhere to the following treatment methods every day.
The treatment is divided into two stages: the first is the elimination stage, and then the maintenance stage. The removal stage is generally through a period of time of normal saline enema, once a day for 3 to 4 days, or until the fecal residue in the rectum is basically washed away. Treatment in the maintenance phase: ①Drugs, use 2 spoons of mineral oil emulsifier, 2 times a day, or other alternative methods, catharsis, enema every other day. ②Diet, high-fiber diet. ③ Training of stool habit. Have regular bowel movements and maintain proper bowel posture, with a calendar record and reward and punishment system.
Third, if children with long-term constipation cannot get better after formal conservative treatment, you need to consult an experienced pediatric surgeon. Once diagnosed as pediatric Hirschsprung disease, sigmoid colon lengthy disease, etc., you need to have an experienced pediatric surgeon for surgical treatment.