REQUEST NOT TO STOP THE GAME THE CAUSE OF CONSILENCE
Constipation problem is the fearful dream of mothers. Frequent constipation in children; It causes many problems such as fever, vomiting, blood in the stool, weight loss. There are many reasons, from the desire to not quit the game to stress, from malnutrition to early toilet training. To prevent constipation, the child should be allowed to sit on the toilet. A warm bath or drinks increase the feeling of defecation. After constipation, the child may involuntarily miss his poop. In such cases, the child should not be punished.
Chronic constipation is one of the most common problems in children. Constipation; It is defined as a decrease in the frequency of defecation, hard or painful defecation (bowel movement). Children aged 1-4 years usually defecate 1-2 times a day, and more than 90 percent of them no later than every other day. To eliminate the problem of constipation in a child, it is necessary to understand how chronic constipation develops. Because many factors can cause constipation in children. However, although it is usually temporary, the most common causes are early toilet training and dietary changes.
CHRONIC Constipation CAN CAUSE OTHER PROBLEMS
Constipation in children is usually seen as a temporary and insignificant condition. However, chronic constipation can cause other problems or be a symptom of another underlying disease. For this reason, if constipation lasting more than two weeks is accompanied by other symptoms such as fever, vomiting, blood in the stool, abdominal swelling, weight loss, painful tears around the anus, and bowel protrusion from the anus, it is necessary to consult a doctor.
CAN HOLD POOL TO AVOID PAIN
The first cause of chronic constipation is painful bowel movements. In such cases, the child learns to hold his poop to avoid pain. When there is a rushed bowel movement, we can hold our muscles for a few minutes and delay it until the emergency passes. Adults can prevent bowel movement in any inappropriate situation, but adults can understand that they need to complete their toilet needs as soon as possible when the situation is appropriate. A child who prevents bowel movement due to fear of pain does this repeatedly, preventing defecation. He crosses his legs to prevent defecation, squeezes his hips, and his facial expression changes. Apart from this, children delay defecation for many reasons. Reasons such as quitting the game and not wanting to go to the toilet in a place other than home can be among them.
DO NOT PUNISH A CHILD WITHOUT POOL CONTROL
In cases of delaying defecation; A large amount of hard stool accumulates in the rectum. Over time, the rectum enlarges and becomes less sensitive to stretching. Pieces of stool separate and the child unwittingly moves into his underwear. This is the situation where the underwear is stained due to fecal incontinence without being aware of it. Sometimes when the colon is contracted, liquid stool will spurt out from around the hard stool in the rectum, giving the impression that the constipated child has diarrhea. In constipation and subsequent stool incontinence, children do not have poop control, they should not be blamed and punished for this. For this reason, they are ashamed, try to hide their dirty laundry and do not want to change their underwear even though the smell disturbs other family members. They also don’t want to go to school because other children make fun of them or because they are embarrassed.
DIET AFFECTS CONSILENCE
Constipation has many causes. One of them is early toilet training. This period can become a war between the child and the parents. Voluntary holding may gradually turn into an involuntary habit. The way of eating is also seen among the conditions that affect constipation. Changes in diet, not consuming foods rich in fiber, switching from a full liquid diet to a solid food regimen can be shown among the causes of constipation. On the other hand, routine changes such as travel, stress, medications, cow’s milk allergy and family history may also be associated with constipation. Whatever the reason, a detailed history review is required. When constipation started, daily activities, previous and current toilet habits, stool frequency, stool shape, whether there is bleeding, medications used, details of diet should be learned. In the examination, it is seen whether there is swelling, mass or lump in the abdomen, rectal location, crack. In addition, rectal examination is performed to check for bleeding. Radiographic imaging of the abdomen provides information about the obstruction status and the location and amount of stool. Based on these findings, it is decided whether further investigations and investigations are required.
TREATMENT METHODS OF CONSILENCE
Emptying the Rectum:
Large hard stools in the intestine are softened and shrunk and expelled. Oral stool softeners work by drawing water into the stool and are not habit forming. They do not pass into the blood and do not stay in the intestine for a long time. Rarely, enemas or suppositories may also be used. These only soften the stool in the lower part of the large intestine and allow it to be cleaned. If the child is very severely constipated, short-term hospitalization and special relief enemas may be required.
Keeping the Rectum Empty
Although bowel movement every 2-3 days is considered normal, this is not the goal for the treatment of children with chronic constipation. In order for these children to have daily defecation and not to accumulate stool mass in the rectum again, defecation should be daily, soft and painless. Having daily bowel movements prevents the accumulation of stool in the rectum again, and ensures that the large intestine comes to normal shape and muscle tone. The intended target with bowel trainers is tried to be achieved. The dose of these trainers is different for each child, and with close monitoring, the correct and sufficient dose can be adjusted for the child. The goal is to provide one or two soft stools a day. It can be mixed with juice to facilitate the intake of trainers. The biggest mistake parents of children who receive treatment to overcome constipation make is to reduce or cut them quickly. When the problem is gone, the trainer’s dose is reduced by 25 percent every 1-2 weeks. If pain occurs again or if daily defecation stops, return to the previous dose.
Dieting
There is no food that causes constipation. There are foods rich and poor in fiber. Therefore, it is necessary to give foods with sufficient fiber amount. Fiber is most commonly found in fruits, vegetables, and grains such as barley, wheat, and corn. Adults should receive 25-30 g of fiber per day, and the fiber requirement in children varies according to age. The fiber requirement of the child is found in grams by adding 5 to his/her age in years. Another important point is to ensure adequate fluid intake. Diet should be a healthy and lifelong habit.
TO RELIEF CONSULTANCY;
* Toilet trained children should be allowed to sit on the toilet.
* After meals and especially breakfast is the best time for toilet training or sitting up. Because a full stomach makes most people feel the need to defecate.
* A warm drink enhances this feeling.
* Sitting on the toilet after a warm bath increases the feeling of defecation.
* For small children to sit comfortably on the toilet, it is helpful to have a small stool or riser placed under their feet and with their knees slightly above the hips.
* Very young children using the potty or facing the wall on the toilet will help them sit more comfortably.
