Constipation the child is not as harmless as it seems at first glance. Headache, lethargy, hemorrhoids, kidney inflammation are just a few of the problems. Why is regular stool retention dangerous? How to deal with constipation in a toddler? What are the symptoms of appendicitis? These and other questions of our readers during the direct line “FACTS” answered pediatric surgeon, professor of the department of pediatric surgery at the P.L.Shupyk National Medical Academy of Postgraduate Education, teacher of pediatric surgery at Kiev Medical University, Doctor of Medicine Vasily Rybalchenko…
“It is more comfortable for a kid to sit on the toilet if there is a stand under his feet”
* – Hello, Vasily Fedorovich! You are worried about Maria from Kiev. My son is three and a half months old, breastfeeding. In the announcement of the direct line, you said that there should be a chair after each feeding, but we have it once a day. Maybe because of this, the baby does not sleep well at night, is capricious during the day?
– Perhaps the baby does not have enough breast milk or it is too thick and fat. While the milk is breaking down, peristalsis slows down. Your mental attitude, the atmosphere in the house is also important. When the baby is awake, the mother is nervous and malnourished, which affects the quality and quantity of milk. In order for the baby’s intestines to work, a volume of food is needed to cause peristaltic waves. The intestines are empty – and the child is restless. After all, the baby lives, in fact, from hand to mouth – he has hungry constipation.
– What to do?
– To have milk, many mothers begin to lean on condensed milk, in which there is an excess of preservatives and other additives, but often not enough cow’s milk. I advise the folk remedy – stinging nettle. You can brew it like tea or squeeze out the juice and dilute it with water. If a nursing mother drinks such a decoction, then her milk will increase.
* – Ludmila from the Kharkov region. My daughter went to kindergarten at the age of three, and problems began with the chair. The teacher says that she sits on the pot without result, and at home it is often the same. I think the problem is that my daughter does not like vegetables, and she eats a little fruit and berries.
– You’re right. For your intestines to work well, you need to eat more fiber-rich foods. But many kids do not like vegetables and refuse fruits. Parents need to use tricks. Promise that after the pumpkin porridge, the son or daughter will receive delicious cookies. And if he eats a tomato salad, he will go to the playground, where there is a swing.
Kefir has a good laxative effect. To choose the most suitable one, try giving kefir from different manufacturers for three days. Record the results in the diary: there is an effect – we mark it in green, no – in red. You can also test different types of juice. From experience I know that pear juice weakens well, although there is no evidence of this in the literature.
There are often psychogenic constipation. In kindergarten, the teacher puts the kids on the potty before and after sleep. But not all children are able to empty themselves by order. The child pushes, and the rectal mucosa can turn out. It is postponed in the baby’s mind: it hurts. Sometimes in kindergarten, teachers scold the child if he emptied into panties. The kid understands: it’s better to keep everything to yourself.
See also: How to treat constipation and hemorrhoids – doctor’s advice
* – Andrey from the city of Vyshgorod, Kiev region. The son (he is five years old) stubbornly does not want to go to the toilet on the toilet – he only requires a potty. What to do?
– The child may be uncomfortable sitting on the toilet. A posture is considered physiological when the rectum is flat, and for this you need to empty yourself on your heels. The way out of the situation is a support under the child’s feet. If the angle between the knee and abdomen is about 35 degrees, then the curved bowel will straighten. It is also advisable to use a child toilet seat. Without it, mucosal loss, cracks, skin irritation (maceration), hemorrhoids can occur.
– At what age do you need to teach a child to use the toilet?
– Everything is individual, but there should be no violence. Encourage your child to use the bathroom like an adult. It is important to establish a daily routine: go to bed at 21-22 o’clock in order to have time for breakfast in the morning and go to the toilet. Then the child will spend the whole day comfortably.
By the way, you need to teach children to go to the potty, and not to the diaper, as early as possible. Due to the fact that a child under three or more years old is in diapers, problems arise. Girls develop genital inflammation, cystitis, urethritis. In boys, spermatogenesis worsens in the future, because nature has provided for the testicles to be at a temperature two to three degrees lower than the body. And in diapers they are like in a thermos, where the temperature reaches 38 degrees. The boy becomes a man, and the couple may have difficulty conceiving. It is believed that half of cases of infertility occur in the stronger sex.
Signs of chronic intoxication
Deterioration in concentration and academic performance.
Weakness and lethargy.
Lack of appetite.
“Pumpkin seed oil has a laxative effect.”
*- Straight line? Marina is from Kiev. The son is three and a half years old. We cannot cope with constipation. We begin to force-feed salads, apples, vomiting occurs. What laxative can be given to children of this age?
– You need to see a doctor. After all, constipation can also be caused by congenital malformations. You can consult in the capital’s children’s hospital No. 1 (Bogatyrskaya street, 30). The phone number of the polyclinic is (044) 201-32-64, the department of general surgery is (044) 201-32-84. If you wish, you can contact me by writing to the email address: [email protected]
Senna drugs or other drugs that stimulate peristalsis are not recommended for children. Addictiveness occurs and an increase in the dose is required. Lactulose-based products are effective, which seem to fluff up feces. Its volume increases, and the urge reflex is triggered. But if the intake of lactulose causes side effects, such as bloating, then in parallel, you should take a drug that reduces gas formation. You can brew chamomile tea to soothe your intestines.
– What else is effective?
– It is good to dress salads with extra virgin olive oil or cold-pressed pumpkin oil, but they need to be masked because many children do not like the taste. The oil stimulates the release of bile, which enhances peristalsis. However, do not force your child to drink oil on an empty stomach – it can cause disgust and even provoke vomiting.
See also: The work of the intestines will improve if you lean on vegetables and fruits and eat soup every day, – doctor
– Olga from Tetiev, Kiev region. A first-grader son cannot go to the toilet at school – only at home. What is the threat?
– Convince your son that it is better to overpower yourself and empty himself in the school toilet, and not restrain the urge – so that psychogenic constipation does not occur. Sometimes this violation leads to spontaneous emptying into the panties, and the psychological trauma intensifies. If fecal incontinence – calamification occurs, then the genitals may become inflamed, the kidneys, the bladder may suffer due to the fact that the infection (mainly E. coli) circulates constantly.
* – Oksana from the city of Kamenskoye. To improve the work of my intestines, my mother gave me a tummy massage in a clockwise direction. Now my daughter has constipation. How do you feel about massage?
– It is useful, but not on an empty stomach. You can also stimulate the movement of food by giving a gentle massage in the area of the descending sigmoid colon. Place your right hand on the baby sitting on the potty on the left side of the belly below, and your left hand on the lower back. Flicking the fingers of the right hand over the tummy, we stimulate the movement of food. After one and a half to three minutes, the child has an urge.
* – This is Evgenia from the city of Khmelnitsky. I am worried about my daughter (she is 15 years old) who eats too little – wants to lose weight. But he suffers from constipation and sits in the toilet for half an hour. What to do?
– Convince the girl to eat more vegetables and fruits, drink plenty of water. Often, adolescents, striving for a beautiful figure, eat too little, and it is difficult for the intestines to function normally. Food is broken down, but a scanty amount of feces is obtained (it is called sheep’s), and the urge reflex does not work. As a result, chronic fecal intoxication occurs. The teenager complains of lethargy, weakness, headache, begins to study worse. Toxins are absorbed, having a detrimental effect on the liver, heart, central nervous system, and other organs. And at the heart of the malaise is a rigid diet for the sake of a figure.
How to improve bowel function
Eat more fiber-rich foods.
Establish a daily routine and sleep.
Do a clockwise abdominal massage or a special finger massage.
“An inflamed appendix that has been treated with antibiotics several times is difficult to detect during surgery.”
*- “FACTS”? You are worried about Lilia from Cherkasy. First, appendicitis was found in his son (he moved to the third grade), and in the winter the appendix had to be removed from her daughter, who is 16 years old. Why does the appendix get inflamed in children?
– There are many reasons. In a newborn, the appendix is wide, but narrows over time. Therefore, mucus evacuation may be impaired. It stagnates, an infection develops, and the appendix becomes inflamed. In older children, worms, bone from fish, grape seed or a lump of feces can get into the appendix, causing inflammation. More often, appendicitis occurs in schoolchildren – students of the third – eighth grades.
See also: How to recognize an attack of appendicitis and whether it is possible to do without surgery, the doctor explains
– How to suspect appendicitis?
– Parents should be alerted by abdominal pain, fever, and unreasonable refusal to eat. The child does not allow stroking the stomach even during sleep – it hurts. You can recognize appendicitis by making a saline enema (a tablespoon of salt per liter of room temperature water to make a two percent solution). If, after emptying, the child began to run, play, asked for food, then this is definitely not appendicitis. But in the case when, after an enema, he continues to walk bent over (older children) or lies with his knees bent, as babies do, you need to go to the children’s hospital as soon as possible, where the patient will receive emergency assistance.
– I read that they treat appendicitis with antibiotics abroad. It is right?
– I don’t think so. Prescribing antibiotics is not an option. Sooner or later, the patient will be “ripe” for the operation. And if the appendix became inflamed several times and the patient was treated with antibiotics, then during the operation it is difficult to find a soldered appendix.
In addition, in European countries and the United States, the salary of a pediatric surgeon is very high. And it is too expensive to keep three children’s specialists on duty at the hospital at night – a general practitioner is on duty. He prescribes antibiotics for all children with abdominal pain. And in the morning, the pediatric surgeon decides who needs to be operated on. According to research data, there are 15-20 such children out of a hundred.
Antibiotic treatment is fraught with dangers. When raising poultry, chicken producers stuff it with powerful antibacterial drugs – fourth generation cephalosporins. Mothers and grandmothers feed their babies with chicken breast, considering it useful, and along with the meat, the child receives powerful antibiotics that increase the bacteria’s resistance to drugs.
See also: Children’s surgeon Olga Gorbatyuk: “With appendicitis, the child’s stomach becomes hard and tense”
* – This is Alexandra, from Kiev. Do children undergo laparoscopic surgery for appendicitis?
– In the Kiev City Children’s Clinical Hospital No. 1, more than half of such interventions are performed laparoscopically. But there are contraindications to the use of a laparoscope, for example, a diaphragmatic hernia. In the West, a child is pre-done with a CT scan of the abdomen, specifying the diagnostic nuances.
I never tire of repeating to parents: do not delay the visit to the doctor if the child has a stomach ache. Many hope that the pain will go away with a warm heating pad or chamomile tea. As a result, the child is admitted to the clinic in a serious condition – with peritonitis, sepsis, multiple organ failure. It is impossible to save such a patient.
Symptoms of appendicitis
Lack of appetite.
A characteristic pose with legs bent at the knees.
Earlier, during the FACTS direct line, children’s gastroenterologist Tatyana Ruban told how to feed a sick child and how to restore digestion after antibiotics.
Photo by Oksana LEVCHUK, “FACTS”