The Underestimated Enemy: Constipation!
Constipation is a difficult condition to treat in childhood. Poorly treated constipation can cause loss of appetite, blood in the stool, painful defecation, and eventually incontinence. It is possible to encounter a situation that disrupts the peace within the family.
A child/baby who has been constipated for a long time may develop a crack in the butt. This causes pain while defecating. The child avoids defecation to escape pain. He holds his poop. Retained poop hardens and eventually comes out, deepening the crack. The process enters a vicious circle. It can be assumed that a child who starts to leak poop has been constipated for at least 6 months. The accumulated poop begins to cover the walls of the last intestine and expand this area. There is a loss of sensation in the hindgut and the contraction ability of the anus is temporarily lost. This causes poop leakage. It is seen that underwear gets dirty all the time. The child who goes to school begins to have difficulties in accepting society. This also affects psychology. Families sometimes apply the punishment method due to this unnoticed situation, which will be one of the biggest mistakes.
Treatment of constipation is quite difficult and requires the cooperation of the family and the specialist doctor. Treatment success can be achieved after a long process. Failures that may occur during this period may cause the family to fall into despair. Acceptance and living with constipation emerge. Or during the long treatment process, the family wonders, "How long will we use these drugs?" may cause concern. However, this vicious cycle can be broken with patient treatment. In addition to medications, nutrition, exercise and sitz baths are used together in the treatment. As a rule, enemas or suppositories are not applied to a child suffering from constipation. The child with a crack in his butt will feel great pain from this procedure and the existing crack will deepen.
Drugs: First of all, discharge treatment is applied with laxatives. Take 1 spoon 3 times a day, mixed with everything you eat and drink. All the hard poop stuck in the corners of the intestines are taken out. This treatment is stopped after the first 3 days as it will wear out the child. During this time, he/she is ensured to drink plenty of water. After the mucilage (day 4), poop softening syrup is started. To morning Dinner starts with 1 scoop. However; The dose that produces soft poop every day is adjusted at home. Some days, if the poop is hard, 2 scoops, 3 scoops may need to be given. Since this medicine does not mix with the blood, there is no harm in giving it too much. Or if the poop is runny, the dose is reduced. Different doses may be needed each day. Using the same dose every day for a long time is also a cause of treatment failure. Once the routine is established in this way, treatment is continued for at least 6 weeks. If there is a period where there is no pooping for 3 days or the stool is as hard as before, the initial laxative treatment is used again for 2 days. However, the 6-week process starts all over again. Stretch mark creams are continued twice a day from the beginning to the end of the treatment. 2 creams are mixed by squeezing the size of a lentil into the palm of your hand and applied to the butt hole as if pressing a bell.
Nutrition: Medicines alone are not enough to treat constipation. Contrary to popular belief, feeding with watery food does not soften the poop. It is necessary to eat fibrous food. Whole grain bread instead of white bread, bulgur pilaf instead of rice pilaf, salad with every meal, and fruit every day.
Exercise: Tell your child to go to the toilet 30 minutes after each meal. “I don't poop.” Even if he says so, make him sit on the toilet for 10-15 minutes. You can play games in the meantime. Let it rise after this period. Make sure your feet are not in the air while sitting. Either choose a potty suitable for his age or place a suitable stool under the toilet. He will need to take strength from his feet while contracting his abdominal muscles. The aim of this exercise is; It is learning to catch the gastrocolic reflex that enables defecation after a meal.
Sitz Bath: For cracks in the butt, sit in warm water for 10 minutes twice a day. If you have a child who crosses his legs and sweats, hides behind the sofa, and cries when he needs to poop; Especially if he/she starts to miss his/her poop, we recommend that you immediately consult your pediatrician before considering psychological reasons.
Dr. Görkem ASTARCIOĞLU
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