Constipation is a very annoying problem, and I suffer from it, but there is no good way. As mentioned earlier, what is called constipation in infants is actually less bowel movements and cannot be called constipation. Here is a discussion of constipation in children (there really is constipation).
What is constipation: Constipation is very few bowel movements, hard stools, accompanied by difficult and painful bowel movements. It even leads to fecal incontinence. In other words, constipation is not defined as how many times a day you have a bowel movement, but rather as having significant difficulty passing stools and having dry stools.
Incidence in children: 95% of infants have one bowel movement per day; 95% of school-aged children have three bowel movements per week. About 5% of school-age children have constipation
Organic disease needs to be considered if the newborn is unable to pass stool on his or her own for more than 48 hours, or if bloating and constipation occur in infancy, or if abnormal signs and weight gain are slow.
What are the causes of constipation?
Idiopathic – that is, excluding organic diseases
1. Frequent holding back of bowel movements
2.Lack of fiber in food and drinking little water
3.Lack of exercise
4, weak intestinal dynamics (familial)
Digestive tract problems
1.Anal problems, including stenosis, fissure, high sphincter tone
2, congenital megacolon
3, food allergy
4, abdominal cavity disease
5, intestinal obstruction (mechanical or dynamic)
Problems outside the digestive tract
1, hypothyroidism
2, hypercalcemia
3, hypokalemia
4, Spinal disorders
5.Abuse
6, Chronic dehydration (diabetes)
7, Medicated (opioids and or anticholinergics)
What are the manifestations of constipation?
1.Low frequency of bowel movements
2.Painful defecation
3.Fresh blood in the stool
4, abdominal pain (diffuse, at night or after meals)
5.Anorexia
6, pseudo-diarrhea
7, intestinal flatulence
8.No weight gain
9, abdominal distension
10.Masses found in the abdomen
11.Anal fissure
12.Increased tension of anal canal
Need to exclude tumor
Management
If there is no organic problem, no special examination is usually required. If organic disease is suspected, thyroid function, serum calcium, allergen test, routine blood, CRP, albumin, anal canal biopsy (suspected megacolon), and anal canal manometry are required. If neurological disease is considered, spinal imaging is required. Abdominal X-rays are usually of no value as they do not exclude pelvic problems.
How is it treated?
General treatment
1.Treat the organic disease present
2.Treat anal fissures (surface anesthetics such as lignocaine cream are commonly used) to relieve pain
3.Increase the intake of dietary fiber, if juice
4. Defecation behavior: defecate for 5 minutes after meals and do not inhibit defecation. Use a sitting toilet with stirrups, parents do not show too much concern and anxiety. Reward can be given after successful bowel movement.
5.Adhere to it for at least 3 months
6.Avoid stimulating food
Special treatment
1.Take oral stool softeners, such as lactulose, at regular intervals
2.Enema
3.Special cases may require hospitalization
Prognosis
Most children experience relief of constipation after passing stools, which can be relieved by stool softening and bowel training. The process is long and requires patience, persistence and understanding of the cause of constipation by the family and the child. Constipation and fecal incontinence can intersect and cause pain for the child and family and should not be underestimated.
Fecal incontinence is an unanticipated bowel movement, such as a bowel movement in the pants. It is not an organic problem, but an emotional disorder, more common in boys. If an organic problem is ruled out, child psychological counseling is available.