Functional constipation
Functional constipation
TSU G. talks to us about constipation, difficult and rare bowel problems. Mariam Ghugunishvili, doctor-pediatrician of the outpatient department of the academic pediatric clinic named after Zhvania.
In children's age, referral to a pediatrician and a pediatric gastroenterologist with the problem of difficult and rare bowel movement is very high. Parents try to alleviate this difficult situation for children at home, they try to give more fruits, vegetables, soups, but often this is not enough.
It is desirable to define at the beginning what is meant by constipation:
Infrequent, difficult, painful defecation with large faecal masses. This complaint is manifested differently in children at different ages, for example:
In children <4 years of age
1. Bowel action ≤2 times during the week
2. At least 1 episode of defecation incontinence during the week "toilet training"-
He regardless.
3. Prevention of defecation in the anamnesis
4. Painful bowel movements in the anamnesis
5. The presence of a large number of fecal masses in the rectum
6. Presence of large faecal masses
In children > 4 years old:
1. Bowel activity ≤2 during the week
2. At least 1 episode of defecation incontinence during the week
3. Strong retention of defecation or posture characteristic of retention
4. Painful bowel movements in the anamnesis
5. The presence of a large number of fecal masses in the rectum
6. Presence of large faecal masses
Epidemiology
• 17%-40% of functional constipation begins in the first year of life
• More than 30% of children have episodes of constipation
• If constipation lasts more than 3 months, it is called chronic constipation (occurs in 10% of children).
• Constipation is often associated with infrequent and/or painful defecation, hard or large stools, faecal incontinence, and abdominal pain.
All parents must know the warning signs of constipation, in the presence of which they should consult a doctor in time.
Constipation that starts very early (<1 month)
Passage of meconium (newborn's first stool) is only accepted after >48 hours
Small stools
Bloody stool without anal fissure
Lack of weight gain
Fever
bilious vomiting
Abnormal thyroid gland
Acute abdominal distension
Perianal fistula
Pathological location of the anus
Absence of anal and crematory reflex
Reduction of lower limb tone, reflexes, tension
Indentation in the coccyx
Extreme fear of anus inspection
Pain in the anus
During the visit to the doctor, the severity, duration, and accompanying problems of the complaints will be evaluated. Often it is not necessary to conduct many diagnostic studies for diagnosis. The doctor will look into the factors that may coincide with the onset of symptoms: the presence of an anal fissure, a change in diet, infections, starting to use the potty, moving house, starting kindergarten or school, fears and phobias, big changes in the family, taking different medications, traveling . The doctor will also perform a physical assessment: height / weight, examination of the anus and its surroundings, palpation of the abdominal cavity (manual examination); In rare cases, it may be necessary to perform an anus (rectal) examination, radiological examination of the abdominal cavity, ultrasonography, laboratory tests to diagnose further diseases: celiac disease, hypothyroidism and hypercalcemia;
In the initial, mild case, treatment begins with simple measures, such as changes in the diet, correction of eating and bad habits - more fluids, fruits, vegetables and fiber-containing foods, encouraging the child in case of defecation.
If all this does not help the baby, then it is necessary to prescribe laxative drugs to soften the fecal blockage, break it up and release the intestinal lumen. Treatment often lasts several months, which is not harmful to the child at all.
It is also necessary to maintain the achieved result. Which means, as we mentioned above, adequate nutrition of the child, avoidance of sweets and bread and cookies, intake of sufficient amount of liquid and fiber, physical activity.
TSSU c. Academic Pediatric Clinic named after Zhvania.
You can contact TSSU g. to the call center of Zhvania Pediatrics Academic Clinic at the number 577 29 34 66
Wish you health!