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Abstract: Parental description: The child had not had a bowel movement for 5 days when he came to our hospital. The child usually likes to eat fried chicken, burgers, barbecue, and various snacks, but does not like to drink water, and his stools have been dry and hard, and he resists when having a bowel movement. He had been to other hospitals for treatment, but the results were not satisfactory. After coming to our hospital, we informed the parents that it was recommended to start with lifestyle habits and give diet modification + exercise control. After the treatment, the child’s stool pattern improved significantly and he was able to have normal bowel movements every day.
Basic information】Male, 5 years old
Type of disease】Pediatric constipation
Hospital】Shanghai Sixth People’s Hospital
Date of Consultation】July 2021
Treatment plan】Lifestyle modification (diet modification + exercise control)
Treatment Period】Outpatient consultation, 1 week of self-management
Effectiveness】Significant improvement in stool condition, able to defecate normally every day
I. Initial consultation
Parent’s description at the time of consultation: She has been constipated since May this year, and there is blood in her anus after defecation. The child is usually naughty and a picky eater, and likes to eat all kinds of snacks, such as chocolate, potato chips, cakes, fried chicken, burgers, etc. He usually does not eat well. According to the teacher’s feedback, he picks meat for every meal, but does not eat vegetables, and does not like to do physical activities. She has a bowel movement only once every 5-7 days, and every time she has a bowel movement, it is very painful, and her stools are very dry and hard. At present, she is considered to be suffering from constipation caused by poor diet and little exercise.
II. Treatment history
Constipation caused by dry stools is usually treated from the living dietary environment by drinking more water and eating more foods rich in coarse fiber, such as prunes, pears, strawberries, avocados, tomatoes, mangoes, beans, sweet potatoes, lentils, corn, peas, broccoli, cabbage, spinach, cauliflower, etc. As a kindergarten-aged child, physical exercise can also be targeted, such as indoor jumping jacks, squats, jump rope, sit-ups, etc., all of which help exercise the abdominal wall muscles and strengthen gastrointestinal peristalsis. Parents should also be informed that their children should be allowed to eat as little refined pasta and cheese as possible. It is also important not to blindly take calcium supplements without clear evidence of calcium deficiency, which can more easily lead to constipation.
III. Treatment effect
After 1 week of treatment, the parents carefully monitored the child to drink more water and eat more vegetables and fruits every day, and basically did not eat snacks and chocolates during the treatment period. The parents also took the child out for running and walking regularly. During the follow-up phone call, the parents described that after a period of conditioning, the child’s stools became significantly softer, the pain during defecation was reduced, and the resistance mentality improved.
IV. Notes
I am glad that after active treatment, the child’s constipation has improved. The point of attention for pediatric constipation is more on good dietary habits, and prevention is more important than treatment. Children like to eat snacks, have the habit of picky and partial eating, prefer to eat meat when eating, and prefer fried food, so parents should consciously avoid exposing their children to such cooking, snacks should be bought sparingly, and these foods or snacks should not be seen within the child’s reach to develop healthy eating habits. In addition, it is also important to develop good bowel habits, so that children can be instructed to have regular bowel movements.
V. Personal insight
Pediatric constipation is a very common disease, first of all, we should do a good job in emotional guidance, not to let the child resist defecation. For school-age children or children who are already in elementary school, it is more important to consciously exercise the habit of regular bowel movements, so that they can adapt to the toilet environment in various places and try not to develop the habit of holding their bowels. If there is no bowel movement for several days in a row and there are related symptoms of food accumulation, such as stomach pain, bloating and loss of appetite, you need to use medication to laxative as prescribed by your doctor to relieve the symptoms as soon as possible.