People think that constipation is a simple problem, not a disease, just a symptom that will not affect anything, staying in a very superficial, traditional, empirical and non-scientific understanding. For constipation, ten doctors will have ten answers: drink more water on the line; more exercise on the line; eat more vegetables on the line; bananas are very good; sesame oil is effective; mamma love can be; honey is good; on fire ah, eat some of the fire bar; change the milk powder bar; or milk powder stop it; with the Keseru ah; use a bar of soap ah; rubbing the belly ah; not yet ah! Then take a picture and do a colonoscopy! Take an enema! Take a laxative! But many children have tried all the traditional methods to drink more water, more exercise, eat more vegetables, eat more coarse grains, bananas, sesame oil, honey, Mommy love, intestinal Run Tong, change the formula, stop the formula, clear the fire, cultivate the habit of regular defecation, cultivate the habit of the toilet, corkscrew, bar of soap, rubbing the skin and so on, especially to drink water, eat vegetables, eat coarse grains has been very much, but still no relief, part of the constipation is more and more serious! The baby has refused to take the initiative to poop due to severe pain in the stool, refused to put the stool. For constipation need to recognize the following facts: pediatric constipation is more common, from birth to teenage, may occur. But the vast majority of functional constipation, there is no obvious organic lesions, the etiological mechanism is not completely clear, but most of the months or years will be better. (This article does not discuss constipation caused by organic lesions, such as congenital megacolon). 1, some pediatric constipation presents a transient, dietary modification after a period of time on their own will improve. 2, but there are pediatric functional constipation is stubborn, treatment is very difficult. Parents must have a correct understanding, and strive for early treatment. 3, persistent constipation through dietary modification, increase water intake, stop or reduce formula feeding, change formula, behavioral interventions (encouragement, training defecation habits, elimination of fear, etc.), increase dietary fiber and other measures have no significant effect. 4, about 50% of the children gradually improve within 1 year, 25% of the children improve within 2 years, and 25% of the children need many years to get better. During this period of time, parents need to correctly understand, can not be impatient, can not rush, and can not sit back and do nothing, and can not reprimand, blame the child. To give the child psychological comfort and guidance, behavioral and dietary adjustments, the most important thing is still to rely on safe, gentle, non-absorbable laxative drugs to maintain long-term treatment, waiting for the child’s gastrointestinal function gradually improve, and then slowly stop using drugs. Many parents repeatedly stop medication in the middle, constipation recurrence, which is not conducive to the continuity and effectiveness of constipation treatment. 5, the child is often constipated because of the severe pain and fear of stool, and therefore will deliberately suppress the urge to defecate, try to delay defecation, so constipation is gradually aggravated, resulting in a vicious circle. Therefore, it needs to be treated as early as possible. 6, long-term constipation leads to a variety of adverse consequences: affect the physical and mental development of the child, the daily fear of psychological stimulation caused by the immeasurable mental psychological pressure, this pressure in turn affects the function of the vegetative nervous system, and further harm the normal physiological function of the gastrointestinal tract; mental stress also affects the development of intellect; rectal anus mucous membrane by the dry and hard stools scratches, lacerations, resulting in localized chronic inflammation, which further affects their function; long-term constipation will lead to less and less rectal tension, less and less sensibility, more and more rectal volume, which will lead to more and more stool accumulation, more and more coarse, more and more difficult to excrete; constipation affects the excretion of toxins, so that toxins in the body will be increased, especially heavy metals; long-term constipation causes intestinal metabolism disorders; however, through effective treatment, it is possible to prevent and treat or greatly reduce such adverse consequences, especially to prevent physical and mental harm to children. Is to prevent the physical and mental harm to children. 7, adult constipation has a very large number of drugs, methods, but the research on pediatric constipation has been lagging behind, especially drug treatment. The reasons are manifold, one is that most parents do not want to take their children as experiments; two is that children can not actively respond to the problem also not easy to cooperate with the research; three is that drug developers are not willing to spend a lot of effort to make a small amount of money. 8, but in the past decade, the United States and other developed countries in children’s constipation to do a lot of clinical trials, so that people have a more scientific understanding of children’s constipation, in the treatment of a more scientific norms, overthrowing some of the empirical methods and traditional understanding. 1), stimulating laxatives are generally used sparingly or not, such as senna, magnesium sulfate, phenolphthalein tablets, fruit guide tablets, rhubarb tablets and so on. 2), anal plug preparations such as corkscrew and enemas can only be used temporarily, to save the emergency use, not as a routine use, not long-term continuous use, because long-term use will cause dependence. 3) Behavioral interventions (e.g., encouragement, toilet training, dietary modification, increased exercise, etc.) are only effective for a small percentage of children, but for most children, they can only help, not play a therapeutic role, and must be used in conjunction with drug therapy. 4), basic drug therapy, the current study that safer drugs are two, polyethylene glycol 4000 (polyethylene glycol) (Note: domestic have Shu Taiqing, divided into A, B package, children can only eat A package; imports seem to have “Fosun”) and lactulose (lactulose) (Note: imports have DuMike), and the lactulose (lactulose) (Note: imports have DuMike), and the lactulose (lactulose) (Note: imports have DuMike). (Note: imports have Du secret grams), they all belong to the osmotic laxative, that is, through the water-absorbing properties of the drug itself, to increase the water content of the intestinal contents, to keep the stool moist. These two drugs are characterized by its own non-toxicity, and basically not be absorbed by the body, can not be decomposed, orally through the intestinal tract directly excluded from the body (lactulose in the intestinal tract can be broken down by intestinal probiotic metabolism), the intestinal tract itself has no stimulation, so it can be safe to take for a long time. Through a large number of clinical trials and follow-up studies, these two drugs have not been found to have any adverse effects on growth and development, nutrient absorption, toxicity test, blood index analysis and so on. However, at present, polyethylene glycol 4000 for children’s constipation has not been written into the instruction manual, but foreign clinics have been used in children. At present, DuMike for children’s constipation has been written into the instruction manual, and pregnant women can also be used, so it should be safer. 5), drug treatment should be adhered to a certain time, until the child to establish normal bowel function. The time may be 3 months, 6 months, 1 year or several years. After a certain period of time, you can try to reduce the dosage and observe whether you can have normal bowel movements, if you are still constipated, you need to continue the medication. 6), the dose of medication: everyone is not necessarily the same, because these two drugs do not have a “ceiling effect”, that is, there is no dosage limit, so it is safe to increase the dose of the drug can be adjusted according to the individual’s situation, the standard is “to keep the stool moist, smooth, stool without effort, no pain, but not too much stool, and not too much constipation. The criteria are “to keep the stool moist and clear, without effort or pain, and without the stool being too loose”. The medication can be used once a day or twice a day. 7), the drug treatment can effectively prevent long-term constipation caused by psychological problems and physical harm, to prevent hemorrhoids, anal fissure, anal fistula, perianal abscess, enteritis, vegetative nerve disorders, metabolic disorders, toxin excretion disorders and a series of complications. After effectively relieving constipation, bowel movement becomes a normal physiological need, even a pleasure to enjoy, rather than a mental and physical burden, in which case it can be better and faster for the affected children to establish a normal physiological defecation mechanism without realizing it. For our country, I have read some literature, combined with my own experience and understanding, summarized as follows: 1, our country is relatively backward in the research and understanding of constipation, especially pediatric constipation. 2.The adverse consequences caused by constipation are not sufficiently recognized. 3. The causes and mechanisms of constipation are complex and no one can explain them clearly at present. 4, nowadays medicine is already evidence-based medicine, that is, any treatment method or means should be scientifically and clinically verified, and should be proved by scientific and strict statistics. Instead of relying on personal experience, individual inferences, subjective assumptions. So now the medical profession is no longer the so-called old experts, but the young and middle-aged scholars, they can read foreign literature without obstacles, always tracking the latest international research results and the latest diagnosis and treatment norms. Additional personal experience: for some stubborn children constipation, especially the constipation of the time between bowel movements more than 3 days, if Dumicol to a certain dose is still ineffective, this case may be better to use polyethylene glycol 4000 effect. The reason is: Dumex can be broken down and metabolized by bacteria in the intestinal tract. Although oral administration of Dumex moistened the feces, if the child did not excrete these stools within 2 days, the Dumex in them may have been basically metabolized by the bacteria, and as a result, the feces in the intestinal tract will become dry and clumpy again. Even though it is taken every day, the Dumex that goes in at the back may not be able to reach the very front of the fecal mass; after all, the medication is a relatively mild one and the doses used in children tend to be on the low side. There are two ways to solve the problem: one is to further increase the dosage of Dumicol (it is felt that at the same dosage, a single daily dose is more effective than splitting it into two); the other is to switch to Polyethylene Glycol 4000, the reason for which, unlike Dumicol, it cannot be metabolized by the bacteria and is retained in the feces, exerting a sustained stool-softening effect. But there is a point to note: although foreign clinicians often give children the use of polyethylene glycol 4000, and in the past few years several clinical trials for children’s constipation proved that the drug laxative effect is better than Dumex, and the same safety, but based on the samples of several clinical trials is still insufficient considerations, the FDA has not yet approved the use of polyethylene glycol 4000 for children’s constipation. The FDA has not approved the use of polyethylene glycol 4000 for constipation in children, so the instruction manual only contains instructions for adults. Although the instructions on the package of the domestic product do not state that it is for use by children, the instructions on the website are labeled for use by infants and children. (If parents are using the domestic Schutethasone, they must know that there are two packages in the package: Package A is Polyethylene Glycol 4000 and Package B is Electrolyte Dispersant, so please don’t give Package B to children). For the imported have Fosamax, have not tried, seems to be a single polyethylene glycol 4000, did not add electrolytes.