Constipation is a very common digestive tract symptom in both adults and children. Many children of all ages come to the pediatric emergency department with constipation problems. Mothers and fathers are usually anxious to tell the doctor about the various symptoms of constipation: long bowel movement time, low stool volume, dry and hard stool, and even painful bowel movement and blood in the stool …… They have also tried various methods: open plug, soap bar anal plug; sesame oil, honey, juice dietary therapy; various laxatives, and the list goes on. Although most of the time constipation is a minor problem, it can also cause children and parents no small amount of trouble. So the following is a brief explanation of the child’s poop that thing. I. What is constipation? Simply put, constipation can be defined as when a child has a significantly lower number of bowel movements than normal, accompanied by straining to defecate, pain and dry, hard stools. It looks pretty simple, but there is a key question – how often is it normal for my child to have a bowel movement? In fact, the answer to this question varies with the age of the child: within the first week of life, most babies will have 4 or more bowel movements per day, and the nature of the stool will be mushy, sometimes even more watery. Even in the case of breastfeeding or hydrolyzed formula (usually also called hypoallergenic formula) feeding, some babies have to poop once when they eat once, while less can only once a week. Later on, the frequency of stools decreases for most babies. After the age of 4, the average is 1 time a day. By adolescence, the average 1-2 days to solve a stool. Finally, I would like to emphasize that the number of times is still different from person to person, each child is different. Moms and dads need to get a handle on their own child’s routine. Although frequency is important, whether or not the child is constipated also depends on the other symptoms mentioned above. Sometimes, even if the frequency is low, but the child’s bowel movements are regular, soft, and there is no special effort or pain during defecation, in this case, it is not considered constipation. Second, why is constipation? Reasons mainly related to defecation habits and diet 1, habits lead to painful defecation: in some cases, when the child is subjectively unwilling or objectively no conditions to toilet, he will temporarily hold back. And the stool that stays in the intestine, its water will gradually be absorbed, resulting in poor defecation behind, causing painful defecation in children. In order to avoid pain, the child will hold the stool for a longer time, which forms a vicious circle: the more not to pull the more pain, the more pain not to pull. One study suggests that 86% of children with constipation are accompanied by painful bowel movements, while up to 97% of children show active restraint in bowel movements. In severe cases, too much stool is trapped in the rectum, causing fecal incontinence. Over time, the rectum dilates, the anus is not easy to relax, the defecation reflex is weakened, forming chronic constipation. 2, diet: dietary fiber is a class of nutrients that will not be digested and absorbed by the body, they mainly play a role in promoting intestinal peristalsis, increasing stool content and maintaining stool moisture. Therefore, if the child’s daily diet of vegetables, fruits and other foods less, more protein, which will lead to a low intake of dietary fiber, may also cause constipation. 3, disease: indeed there are a small number of constipation is caused by the disease itself, such as congenital megacolon, congenital malformation of the rectum and anus, milk protein allergy, hypothyroidism, autism spectrum disorders, the application of narcotics or anti-allergy drugs, etc. In addition, some children have a family history of constipation. These are all conditions that require other medical management and will not be discussed here. Because the occurrence of constipation is related to the above factors, special attention should be paid in certain cases to observe the presence of constipation, intervene and encourage the child to defecate in a timely manner, thus interrupting the vicious cycle and preventing chronic constipation. The first is when the infant starts to add solid food; the second is when the child learns to use the toilet; the third is when the child enters kindergarten or school, and the fourth is during short-term trips, especially when traveling with a group. Third, what are the phenomena that indicate that the child may be constipated? Usually, the symptoms include: the frequency of defecation suddenly decreases compared with usual; the stool is often dry and hard, and sometimes the hard stool is covered with a layer of shiny mucus; the child often tells you that it is painful and painful to defecate, and the child will show it by bending over and arching his back or crying; the child repeatedly stamps his feet like dancing and covers his buttocks with his hands, but he does not want to go to the toilet; the child who is already able to go to the toilet by himself sometimes has the overflowing stool on his underwear. If you are able to go to the toilet by yourself, your underwear is sometimes covered with overflowing feces. However, there is another condition that needs to be distinguished from constipation, which we call infantile dyspareunia, and which often occurs in small children under 6 months of age. This is often seen in babies under 6 months of age, who struggle to defecate, their faces can be red and they can even cry, but the stool is very soft. This is caused by the fact that babies are not yet able to coordinate the relationship between intra-abdominal pressure and the pelvic floor muscles when they defecate, and is also a process of continuous learning for babies. This phenomenon is completely normal and usually disappears after a few weeks, so some interventions, such as anal stimulation or even the application of laxatives, are not necessary. Fourth, the child has been constipated what to do? 1, short-term and not serious, the first thing you can do is to make some changes in your baby’s daily life. For children over 1 year old encourage them to eat more fruits (pears, bananas, oranges, apples with skin, etc.) or certain raw juices with meat (pear juice, apple juice, but generally the amount does not exceed 180ml/day), vegetables (spinach, bamboo shoots, beans, mushrooms, etc.) in their diet, choose whole wheat for breakfast bread, and drink more water (in addition to milk, over 2 years old can be supplemented with more than 900ml of water). If constipation does not improve, try not to eat dairy products (including fresh milk, yogurt and cheese) for 1-2 weeks (if it does not work, you do not need to abstain from dairy products for a long time). In addition, develop the habit of going to the toilet regularly, and encourage your child to try to have a bowel movement 1-2 times a day, preferably about 10 minutes after a meal, even if there is no bowel movement yet. Even if the stool is not removed, parents should praise the child instead of blaming him/her. If constipation occurs in infants over 4 months old, you can also choose the above-mentioned juice (60-180ml/day, increase or decrease according to the size of the month), oatmeal instead of rice paste, etc., but be careful not to reduce the intake of iron-containing supplements. 2. Long-term chronic constipation should be treated under the guidance of a doctor. The anal administration of corkage can be used to help expel the dry and hard stools already present in the intestines, and this is preferred for children with strong fecal impaction. However, once the blockage is lifted, it should not be used frequently, as it interferes with the defecation reflex. For some irritating laxatives, such as the commonly used senna, should only be applied for a short period of time under the supervision of a doctor, while repeated application over a long period of time can lead to colon melanosis and increase the chance of colon cancer. Taking sesame oil and paraffin oil can also help lubricate the intestines, but they are not safe for small infants and children with GERD. Therefore, doctors usually recommend a laxative to maintain treatment for a period of time. Lactulose is available for both infants and children, and polyethylene glycol is also available for ages 6 and older. These two drugs are not absorbed by the intestine and soften the stool by increasing the osmotic pressure in the intestinal lumen and increasing the water and volume of the stool. Current studies have confirmed that both drugs are very safe and effective. When do I need to seek medical attention? Mothers and fathers need to be alerted to the following conditions and should be examined by a pediatrician as soon as possible: constipation that occurs within 4 months of age. Constipation in this case and may be caused by other diseases that need to be examined and ruled out by the doctor. The above-mentioned methods have been used, but after 24 hours, the child still has not had a bowel movement. The child’s stomach hurts so much that it is unbearable and interferes with activity, or it is accompanied by vomiting or does not pass a fart for a long time. Frequent constipation requires a doctor to rule out other potential problems such as perianal abscesses, fissures, or even psychological problems. The presence of blood in the stool.