Dry weather, beware of pediatric constipation Over the past few days, the persistent lack of precipitation has led to dry weather, and more babies have come to the pediatric surgery clinic of the Third Affiliated Hospital of Zhengzhou University for treatment of constipation. Many parents and friends are anxious when they see their babies having dry stools, struggling to defecate, and not passing stools for days at a time. For this symptom, every parent has a set of their own treatment experience: some give more water, honey, some give more vegetables, fruits, some give more activities, and some really have no way to give the treatment such as corkscrews, laxatives, etc. However, about pediatric constipation, we have a lot of experience in treating constipation. However about pediatric constipation, how much do we know? Let’s learn how to deal with pediatric constipation. First of all, pediatric constipation is relatively common, from birth to teenage years, 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. However, before identifying functional constipation, it is important to go to the hospital to rule out congenital megacolon, anal stenosis and other organic lesions. If it is organic lesions, most of them need surgical treatment. Some children’s constipation is transient, after a period of time after dietary modification will be improved on their own. However, some pediatric functional constipation is more stubborn and very difficult to treat. As parents must have a correct understanding, and strive for early and reasonable treatment. For children with persistent constipation, often 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 are not obvious results. However, for children with persistent constipation, about 50% of them will gradually improve within 1 year, 25% within 2 years, and 25% will take many years to improve. During this period of time, parents need to correctly understand, not impatient, not eager to achieve, not to sit back and do nothing, not to reprimand, blame the child. To give the child psychological comfort and guidance, behavioral and dietary modification, 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 improved, and then slowly stop using drugs. Here to say is that many parents repeatedly stop the drug in the middle, constipation recurrence, this is not conducive to the continuity and effectiveness of constipation treatment. Constipated children often because of constipation pain and fear of bowel movements, and therefore will deliberately suppress the urge to defecate, as much as possible to delay defecation, so constipation is gradually aggravated, leading to a vicious circle. Therefore, it needs to be treated as early as possible. Long-term constipation is also prone to lead to a variety of adverse consequences: affect the physical and mental development of the child, the daily fear of psychological stimulation caused by the potential mental psychological pressure, which 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 the function of the; long-term constipation, it will deliberately suppress the desire to defecate, so gradually aggravated. ; long-term constipation will lead to less and less rectal tension, less and less sensibility, more and more rectal volume, which also leads to more and more stool accumulation, more and more coarse, more and more difficult to excrete; constipation will affect the excretion of toxins, so the body will increase the number of toxins, especially heavy metals; long-term constipation will cause intestinal metabolic disorders; however, through effective treatment, you can prevent or greatly reduce such adverse consequences, especially Prevent physical and mental harm to children. At present, for the drug treatment of pediatric constipation, we suggest: 1, stimulating laxatives are generally used sparingly or not, such as senna, magnesium sulfate, phenolphthalein tablets, fruit guide tablets, rhubarb tablets, etc.; 2, anal plugging preparations, such as corkscrew, and enemas try to be used as a temporary, emergency use of the method, not as a long-term treatment, because of its long-term use of the child will cause a certain degree of psychological negative impact, and affects the child’s normal defecation habits of the Establishment of normal bowel habits. 3, behavioral interventions (such as encouragement, toilet training, dietary modification, increase exercise, etc.) is only effective for a small number of children, but for most of the children, can only play a role in helping, can not play a therapeutic role, it must be combined with drug therapy; 4, basic drug therapy, the current study that the safer drugs there are two, polyethyleneglycol 4000 (polyethyleneglycol) (Note: Domestic has Shu Taiqing, divided into two parts: polyethylene glycol 4000 and Polyethylene glycol 4000). Domestic Shu Taiqing, divided into A, B package, children can only eat A package; imports of “Fusong”) and lactulose (lactulose) (Note: imports of Du secret grams), they belong to the osmotic laxative, that is, through the drug itself absorbent properties, increase the water content of intestinal contents, to keep the stool moist. These two drugs are characterized by its own non-toxicity, and is basically not 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 intestinal probiotic bacteria decomposition and metabolism), the intestinal tract itself has no irritation, so it can be safely taken 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 has not been used in large quantities in China for the treatment of children’s constipation. Lactulose has been more commonly used for children’s constipation treatment. 5, drug treatment should adhere to a certain period of time, until the child to establish normal bowel function. Time may be 3 months, 6 months or longer. After 2 months after the effect can try to reduce the amount, to observe whether the normal bowel movement, if still constipated, then need to continue to use the drug. 6, the dose of drugs: everyone is not necessarily the same, because these two drugs without “ceiling effect”, that is, no dose limit, so you can safely increase the dose of drugs can be adjusted according to the individual situation of the medication, the standard is “to keep the stool moist, smooth, stool without effort, no pain, but not too loose stools. The criteria are “to keep the stool moist and clear, with no effort or pain, and without the stool being too loose”. The medication can be used once a day or twice a day. 7, medication can effectively prevent the psychological problems and physical harm caused by long-term constipation, prevent hemorrhoids, anal fissure, anal fistula, perianal abscess, enteritis, vegetative nerve disorder, metabolic disorders, toxin excretion disorders and a series of other complications. After effectively relieving constipation, bowel movement becomes a normal physiological need, and even a pleasure to enjoy, rather than a mental and physical burden, in which case it can be better and faster for the child to establish a normal physiological defecation mechanism without realizing it.