constipation in children
Introduction
Introduction Constipation refers to difficulty in defecation for 2 weeks or more. The incidence of constipation in children in the normal population is 0.3% to 28%. It is generally believed that the definition of constipation should include the following four aspects: (1) the number of bowel movements is less than 3 times/week, and in severe cases, the bowel movement can be 2-4 times a week; (2) the defecation time is prolonged, and the severe defecation time can be long. More than 30 minutes; (3) changes in stool characteristics, dry stool; (4) difficulty or difficulty in defecation, there is a feeling of defecation. Constipation in children can be divided into two categories, one is functional constipation, this type of constipation can be cured after conditioning; the other is constipation caused by congenital intestinal malformation, this constipation can not be cured by general conditioning, Must be surgically corrected.
Cause
Cause
1, dietary factors
If the baby eats too little and the amount of sugar in the diet is insufficient, it can cause less residue after digestion and less stool. The high protein content in the diet makes the stool alkaline, dry, and reduced in number. More calcium in food can cause constipation. For example, milk contains more calcium than human milk, so cow milk has more chances of constipation than breastfeeding.
2. Insufficient intake of dietary fiber
Because many children do not like vegetables, like high-fat, high-cholesterol foods, some parents who lack health knowledge do not know the guidance, which causes slow gastrointestinal motility, indigestion, food residues in the intestines stagnant for too long, causing constipation .
3. Habit factors
Constipation can occur due to irregularity in life or lack of regular bowel movement training, or individual children who have sudden environmental changes.
4, disease
Children with rickets, malnutrition, and hypothyroidism have poor abdominal muscle tension, or weakened bowel movements, and constipation is more common. Anal fissure; inflammation around the anus, pain in the anus at the time of stool, the child does not resolve the stool due to fear of pain, leading to constipation. Children with congenital megacolon have constipation, bloating and vomiting shortly after birth. When the abdominal tumor is pressed close to the intestinal lumen, the stool cannot pass smoothly, and constipation can also be caused.
Examine
an examination
Related inspection
Conventional fecal traits feces volume stool color abdomen auscultation
1. Fecal routine and occult blood should be routinely examined.
2. Inspections related to biochemistry and metabolism. If the clinical manifestations suggest that the symptoms are due to inflammation, tumors or other systemic diseases, hemoglobin, erythrocyte sedimentation rate, and biochemical tests (such as thyroid function, blood calcium, blood sugar, and other related tests) should be tested.
3. Anorectal digital examination, you can understand the function of the tumor and anal sphincter. It is also a common and simple way to judge the presence or absence of obstructive constipation. In particular, the enhanced sphincter tension, when the force is defecation, the sphincter can not be loose, but more contraction and tension, suggesting that the long-term extreme laborious defecation, leading to sphincter hypertrophy, and at the same time in the forced defecation is contradictory contraction.
4. Colonoscopy or barium enema helps to determine if there is an organic cause. Especially when there is a recent change in bowel habits, blood in the stool or other alarm symptoms (such as weight loss, fever), a full colon examination is recommended to determine whether there are organic lesions such as colon cancer, inflammatory bowel disease, colon stenosis, etc. .
Diagnosis
Differential diagnosis
Differential diagnosis of constipation in children:
1, bowel habits change: stool time changes, stool is irregular.
2, abnormal stool discharge process: abnormal stool discharge process (urgency, defecation, and effort) is one of the clinical diagnosis of irritable bowel syndrome. Irritable bowel syndrome (IBS) is a type of gastrointestinal function that is associated with chronic or recurrent abdominal pain, diarrhea, bowel habits, and abnormal bowel traits, and lacks gastrointestinal structural or biochemical abnormalities. The syndrome is often associated with other functional diseases of the gastrointestinal tract such as gastroesophageal reflux disease (GERD) and functional dyspepsia (FD).
3, secondary constipation: Any constipation on the basis of organic diseases or diseases, known as secondary constipation, also known as symptomatic constipation.
4, primary constipation: primary constipation refers to constipation caused by the absence of organic diseases.
