Constipation in children. Treatment of constipation in children Video about the treatment of constipation in a child: how to treat constipation in a child under one year old, what causes constipation in children

12.03.2024 -

Problems with stool indicate disturbances in the gastrointestinal tract. In childhood, the danger lies in the fact that parents often ignore this issue, and the child simply cannot explain what is bothering him. Experienced pediatricians at Professor Gorbakov's Clinic know everything about the causes and treatment of constipation in children and are ready to provide you with qualified assistance in resolving this situation.

The most common causes of constipation in childhood are:

poor nutrition with a predominance of fatty and protein foods and lack of fiber;
chronic fluid deficiency;
imbalance of intestinal microflora;
food allergies;
enzyme deficiency;
helminthiasis;
rickets;
iron deficiency;
hypofunction of the thyroid gland;
drug abuse, etc.

In addition to chronic and functional, psychological constipation in a child is also not uncommon. They are caused by unfavorable conditions around them. This happens, for example, during adaptation to kindergarten, in an unfamiliar environment, during potty training.

Why is it so important to treat constipation in childhood?

Systematic problems with bowel movement have a negative impact on the functioning of the body:

nutrients, vitamins, microelements are poorly absorbed - anemia and vitamin deficiency develop;
decay products poison the body - the result of intoxication is lethargy and drowsiness;
the body's resistance to diseases decreases;
the intestinal mucosa becomes inflamed, gas formation increases, local blood circulation is disrupted;
cracks form in the rectum - the child is afraid to go to the toilet, and over time the neurological aspect joins.

Principles of therapy at the Gorbakov Clinic

Glycerin suppositories or a cleansing enema will only temporarily solve the problem, but will not eliminate its root cause. In our center, as part of the treatment of chronic, functional constipation in children, they pay attention to finding the source of the problem, and also fight unpleasant symptoms. The child undergoes a series of tests and also undergoes consultations with specialized specialists, which helps to see the clinical picture as a whole.

When prescribing treatment for constipation for an infant or small child, the pediatrician takes into account age, severity of the disease, presence of pain, psychological state and a number of other factors. That is why our forecasts are always favorable. If the problem has affected your family, do not rush to try all the methods you know on your son or daughter: make an appointment at the Gorbakov Clinic to keep your child’s health under control!

Every person, at least once in his life, suffered from constipation. In most cases, they passed without any medical intervention, in extreme cases, with the help of grandmother’s remedies. That is why parents sometimes do not pay due attention to the appearance of constipation in their children, hoping that gradually everything will work itself out, thereby wasting precious time and dooming their children to suffering. Whereas, by contacting a specialist with this problem in time, they will be able to more competently help their child.

Modern medicine considers constipation one of the most common pathologies of the gastrointestinal tract found in children. This disease is a disorder of intestinal function caused by an increase in the time between bowel movements, as a result of which stool accumulates in the intestines, disturbing the balance of microflora and causing pain.

In newborns, the number of bowel movements coincides with the frequency of feedings and can reach six times a day. By the time they start complementary feeding, these children have stool no more than twice a day. Children receiving artificial nutrition also have stools twice a day.

In addition, constipation is not only the retention of stool itself. So, the number of bowel movements may be normal, but they are painful, the child strains a lot, and the feces have a denser consistency - there are signs of chronic constipation.

In addition, constipation can be of functional or organic origin. The first is caused by miscalculations in the nutrition of a nursing mother, lack of fluid in the child’s body, early weaning and transfer to artificial feeding, the presence of damage to the central nervous system, rickets, iron deficiency, intestinal dysbiosis, food allergies, as well as suppression of the reflex to defecate (as This usually occurs in shy children).

Organic constipation appears as a result of anatomical defects in any part of the large intestine, or as a result of surgical interventions in the abdominal cavity.

Conservative treatment of constipation in children includes drug therapy, physiotherapeutic procedures, massage, physical therapy, diet therapy, and mechanical bowel movements using enemas. Surgical intervention is designed to restore intestinal patency.

If your child has a swollen tummy and increased gas formation, you should give him dill water, chamomile or fennel tea. It will not be superfluous to learn how to give an enema, as well as suppositories with glycerin. But remember, serious drug treatment should only be carried out by a doctor!

Excellent prevention of constipation is massage, gymnastics and a balanced diet for your child.

Abdominal problems very often bother children in the first year of life, when the intestines are not yet sufficiently developed. However, constipation can also occur in a child at an older age, when the causes of this condition should be sought in the field of psychology.

Gastroenterologist, Candidate of Medical Sciences, director of the evidence-based medicine clinic “Rassvet” Alexey Paramonov tells Letidor why constipation occurs in children, what diet should be followed and what medications will help the child.

What is considered constipation in children under one year of age?

When we're talking about adults and older children, constipation is bowel movements less than 3 times a week and/or hard, painful stools.

In infants, it is not the frequency of stool that is of greater importance - it normally varies widely, but the second part of the definition - dense, putty-like and painful stool.

The frequency of stool in children under one year can be from 5 times a day to once a week.

If at the same time the child feels well, there is no unusual painful bloating, and the stool is soft and passes easily, weight gain is normal - the child is healthy, there is no need to treat him.

If the child is only breastfed, then there is a high probability of infrequent bowel movements - up to once a week.

This happens in cases where milk is digested and absorbed very well. The color of the stool is not a problem - it can be from light yellow to dark green and is determined by the depth of processing of bilirubin excreted in bile. Treating stool color is a very bad idea.

When will we say that an infant is constipated? If the stool is dense and, which is especially important for babies, putty-like. If the tummy is swollen, the child screams when the abdomen is palpated, screams at the time of defecation, and after bowel movement everything returns to normal for the time being. This situation cannot be ignored. In severe cases, infants may develop intestinal obstruction and require urgent surgery.

Cause of constipation in infants

The main cause of constipation at this age, if you do not take rare severe hereditary diseases, is the functional immaturity of the intestinal nervous system. The intestine has not yet learned to move its contents to the exit, water is absorbed, and putty-like feces block the lumen of the intestine and pass away with difficulty. It is clear that no “dysbacteriosis” plays a role in this process, and no tests for bacteria or their “susceptibility to phages and antibiotics” are required.

How to treat constipation in children under one year old

Often with age, constipation goes away on its own; vegetable and fruit complementary foods often have a positive effect. But if this is not enough, laxatives must be prescribed. For children of this age, mainly osmotic and bulk laxatives, as well as emollients, are used.

Macrogol (polyethylene glycol) preparations play an undoubted leading role. They are present in our pharmacies under a dozen names from different manufacturers, and are also available in special children's dosages.

Macrogol is a polymer, a large synthetic molecule that is not absorbed, does not enter the blood, remains in the intestinal lumen and is released with feces.

The function of macrogol is to retain water in the intestinal lumen, increase the volume of feces, make them softer and ensure easier evacuation. I called macrogol a leader primarily because studies have proven its ability to prevent obstruction and associated hospitalizations and surgeries.

Today, macrogol preparations have no competition in terms of the quality of the evidence base when used in children; they are the ones recommended by clinical guidelines for constipation (guidelines) in most developed countries.

Lactulose is of less importance; its main disadvantage is that it can cause gas formation and bloating. Symptomatically, local stimulants - suppositories with glycerin and microlax - can be used as needed, but the need for their use indicates the insufficiency of the main treatment. In a year and a half, stools usually normalize and the intestines begin to function normally.

Constipation in children over two years of age

But at the age of 2-3 years, functional constipation can already form, the nature of which largely has a psychological basis.

It is enough for a child of this age to experience occasional constipation once, which was associated with a malnutrition, dehydration, or the inability to go to the toilet due to being away from home.

And if constipation ends with a painful bowel movement, the child is afraid of a repetition of the pain and may hold back feces, which aggravates the situation and makes subsequent bowel movements even more painful.

The socialization that accompanies this age can become an aggravating circumstance.

A child may feel uncomfortable going to the toilet in kindergarten, but he endures it all the way home. But the intestine is designed in such a way that if you regularly suppress the urge to stool, the bowel reflex is suppressed and the intestine becomes sluggish. The feces are delayed, become dense and dehydrated - and in this situation a phenomenon may occur when constipation is combined with the involuntary release of the liquid part of the feces. This phenomenon is called stool smearing, or encopresis. It is based on fecal sludge - the dense part of the feces is located in the rectum, and the liquid part flows around it and, freely flowing out, stains the laundry. This process is beyond the child’s control; the comments and punishments he receives in connection with this misfortune aggravate the course of functional constipation.

Constipation can occur at any age. Such disruptions in the functioning of the gastrointestinal tract often bother children. Constipation in a child manifests itself in difficult bowel movements. The problem is not a separate disease, but is considered only a symptom of various ailments. Children are bothered by such stool disorders quite often. According to statistics, constipation occurs in almost 17.6% of children under one year of age. At older ages, such disorders occur in 10–25% of children. At the first sign of a problem, parents should immediately take their child to the doctor. Self-medication can cause the baby to develop serious complications, including intoxication of the body.

Doctors say that both biological and psychological factors can provoke the development of this symptom. The following are the most common causes of constipation in children in medical practice:

Insufficient amount of water your baby drinks per day.
Fever, viral diseases.
Intestinal innervation disorders;
Intestinal obstruction;
Abnormalities of intestinal development;
Enzyme deficiency;
Being too persistent in potty training your child.

Constipation in school-age children associated with psychogenic causes may occur due to the inconvenience of using a public toilet. As a rule, this is due to the presence of other guys in it.

What diseases can cause constipation in a child?

Most often, such disorders in children appear due to intestinal malformations. Constipation can be caused by the following congenital ailments:

rectal atresia;
dolichosigma;
Hirschsprung's disease;
ectopia of the anus.

They can also occur due to acquired diseases, for example:

malnutrition;
peptic ulcer;
rickets;
diaper dermatitis;
gastroduodenitis;
dysbacteriosis;

Diagnosis of the baby

You can find out approximately what caused your child’s constipation at home by taking a self-diagnosis test on our website. The test result is only approximate and must be confirmed by a pediatrician at your appointment. Pediatricians will help you cope with this problem. First of all, the doctor makes a diagnosis. He asks when exactly the child’s constipation began, what the color and consistency of the stool is. Next, the doctor conducts a visual examination of the baby. To identify developmental disorders of the colon, the doctor performs a digital rectal examination. This helps to assess the condition of the anus, detect pathological changes, as well as foreign bodies. To confirm the preliminary diagnosis made by a specialist, the following procedures are prescribed:

Which doctor treats you?

If your child has constipation, you should consult a doctor in the following specialty:

After the examination, the doctor will prescribe the necessary diagnostics in your case. Some diseases are difficult to diagnose, as they say “by eye”. Therefore, you need to trust your doctor when prescribing tests. After all the tests, the doctor will be able to formulate the correct course of treatment. Remember: accurate diagnosis and correct diagnosis are already 50% of success in treatment!

What to do if your child is constipated?

Stagnation of feces leads to disruption of the normal intestinal microflora, and toxins released from feces begin to be absorbed into the blood. Therefore, you need to know what to do if your child is constipated. It is very important to consult a doctor promptly if such problems occur. However, you can help your child even before seeing a specialist. At home, cleansing enemas will help you empty your bowels. Special baby glycerin suppositories can also help your baby defecate. However, using them too often is not recommended. It is strictly forbidden to give laxatives to children without a doctor's permission. Only a doctor can choose a medicine that will not harm the baby. You should immediately consult a doctor if you experience chronic constipation in children. Also, you should not hesitate to visit a specialist if there are streaks of blood or mucus in the stool.

At the Children's Medical Center "Human Health", the treatment of constipation in children is selected individually, prescribed medications are prescribed in strict dosages after collecting anamnesis and. For a solution to such a delicate problem as constipation, parents can contact our center in the North-Eastern Administrative District at the Otradnoye metro station.

When should you worry?

Normally, the baby should walk in a big way every day. If this does not happen, it is worth considering whether the baby is experiencing problems with bowel movements. Every baby may occasionally experience this delicate problem, and this is normal. But if the baby has problems with bowel movements for two weeks, constipation becomes chronic, and you should immediately contact your pediatrician. You should immediately show your child to a doctor if you have the following symptoms:

abdominal pain;
bloating: the baby kicks his legs, his face turns red when he pushes;
bleeding that can be found in the stool or diaper;
rare urge to defecate.

In some cases, constipation can be confused with. It is worth knowing that in the second case, the feces are never dry and hard.

What is the reason for rare bowel movements in a child?

The most common reasons are the following:

lack of fiber in the diet (vegetables, fruits), excess of sweet foods and processed foods;
fluid deficiency;
a sudden change in nutrition, for example, switching from breastfeeding to artificial feeding, switching to whole cow's milk, or untimely introduction of complementary foods;
Older kids may thus rebel against going to the potty;
physical inactivity in children sometimes leads to intestinal muscle atrophy, which also affects peristalsis;
fear of pain from bowel movements, previous constipation - children may deliberately not go to the toilet;
psychological trauma;
a change of environment, a trip, a new toilet, a potty can affect the children’s desire to walk;
illness, loss of appetite can also lead to this delicate problem;
taking medications.

Constipation should not be viewed as a harmless ailment. If the problem is not addressed, constant stress on the intestines can lead to anal fissures, hemorrhoids, and anal ruptures. Forceful pushing in infants can cause rectal prolapse, fecal incontinence, and bleeding.

Treatment

First you need to determine what the cause of the disease is and solve it. To exclude a possible pathology, it is necessary. After that it stands. He usually recommends the following treatment regimen for newborns:

a warm bath or heating pad on the stomach to relax the intestines;
massage the abdomen and perform circular movements with the legs, as when riding a bicycle;
in extreme cases, a warm water enema or a glycerin suppository;
in some cases - a mild laxative.

Parents are not recommended to self-medicate and immediately switch to enemas, suppositories or baby soap. For older children, the doctor usually prescribes a diet rich in fiber and recommends eliminating fatty foods. It is also worth taking care of active pastime and games in the fresh air. In extreme cases, the baby is prescribed medications that improve intestinal microflora and a laxative.