Children with severe constipation: Is enemas good for children?

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1. Causes of constipation in children

Constipation is a condition in which stool moves slowly in the colon, the stool is absorbed a lot of water, so it is dry, hard or round like goat poop. Children have symptoms of constipation if they have less than 2 bowel movements/day for infants, less than 3 bowel movements/week for breastfed babies and less than 2 bowel movements/week for older children.
Children with constipation often have to push a lot, leading to burning pain, even anal fissures, anal bleeding or rectal prolapse. This makes children obsessed, afraid to defecate, making bowel movements more difficult. Constipation in children, if not treated promptly and properly, will cause many consequences such as anorexia, flatulence, abdominal distension, indigestion, vomiting, stunted children, malnutrition and growth retardation.
Causes of constipation in children, including:
Physical causes (rare, usually accounting for 5% of causes of constipation) are mainly congenital malformations such as megacolon (disease) Hirschsprung), hypothyroidism (Myxoedeme disease), Down's disease. When suffering from these diseases, babies often show signs of constipation very soon after birth. Acquired causes such as anal fissures, hemorrhoids, anal spasms, paralysis, spinal diseases. Constipation can be caused by an incorrect diet such as eating too much protein, drinking less water, eating less green vegetables and fruits, leading to a lack of fiber, making milk too thick, drinking too much milk every day, especially milk. Cows, children eat a lot of fast food, sweet food Decreased muscle tone of the intestinal wall in some diseases such as anemia, rickets, malnutrition, ... or due to taking drugs such as cough suppressants with codeine, anti-dynamic drugs menstrual period, anticonvulsant drugs, ... Psychological factors are afraid of dirty or afraid to defecate

2. Measures to help children improve constipation

Depending on the cause of the child's constipation, there are appropriate treatments. In general, to improve the problem of children with constipation, parents need to understand the following principles:
Give children plenty of water: Babies under 6 months of age need to be exclusively breastfed, so they hardly need to drink water. . But if the baby is constipated due to the influence of the mother's diet (the mother eats less fiber), the baby should drink 100-200 ml of water per day. For older children, the amount of water that needs to be added to the child's body depends on the age. Children aged 6-12 months should drink about 200-300 ml of water daily. Children from 1-3 years old need to drink 500-600 ml of water per day. Children aged 3-5 years need 1000ml of water/day. Children over 10 years old need to drink the same amount of water as adults, from 1.5 to 2.2 liters per day. In addition to feeding children with all four important groups of nutrients in their daily meals, parents need to give their children plenty of green vegetables and fruits. Choose vegetables with laxative properties such as sweet potatoes, spinach, and amaranth. It can be chopped and boiled, steamed or cooked for children to eat. Give your child fruit and vegetable juice to drink 3-4 times a day. When cooking powder or porridge, it is advisable to add pureed vegetables for children to eat. Give your child fruits such as grapefruit, banana, papaya, dragon fruit, oranges, and tangerines (it is better to eat whole pieces). Limiting children with constipation to eat acrid fruits such as guava, sapodilla,... Fruits can be cut into small pieces for children to hold or pureed into smoothies to drink every day. If the child is constipated due to drinking cow's milk, it is recommended to dilute the milk a little more or mix the milk with porridge cooked with vegetables and fruits for children aged 5 months and older. If changing the diet cannot improve the child's constipation, parents can use some drugs such as: in the morning give the child paraffin oil, drugs containing magnesium sulfate with laxative effect or The drug contains live bacteria in the form of freeze-dried such as microbial nuggets to balance the intestinal flora. Enemas are a last resort for constipation, but parents should only follow their doctor's orders. Support to increase bowel movements for children by massaging the abdomen in a clockwise direction from 3 to 4 times a day, for about 5 minutes each time, in between 2 meals. When massaging, the mother can press deeply on the lower left abdomen to stimulate peristalsis. Form children the habit of defecating on time. Should choose a time to defecate when the child is not in a hurry, usually right after a meal because bowel movements are increasing at this time. Children should not sit on the toilet or potty for too long. In the case of children with constipation due to anal fissures, parents should wash the anus and apply 2% silver sodium solution to the anus. In addition, parents should also pay attention and treat accompanying diseases (if any) such as anemia, rickets, and malnutrition so that children can absorb nutrients effectively.

3. Children with severe constipation should do?

Constipation can be mild or severe, even some children have been constipated for 5 days without having a bowel movement. What should I do if my child is severely constipated? This is a common question asked by many parents. As discussed above, enemas seem to be a last resort that can be done at home if your child is severely constipated. However, many parents still do not really understand whether enemas for children are good or not. In fact, enemas for children at home can still be performed, but parents clearly understand the following notes:
Only enemas are prescribed and guided by a doctor. Enema using warm water mixed with glycerin or honey. The amount of enemas is about 30-40ml for children under 1 year old and 100-250ml for children over one year old. Do not enema many times or improperly can hurt the child's anus. Do not abuse enemas to solve the child's constipation because it can cause dilation of the sigmoid colon and rectum, causing the child to lose reflexes. Spontaneous defecation and habit formation without enema, children will not be able to defecate on their own. Especially, for children with severe constipation, if they have the following signs, they should take them to the hospital right away: constipation lasts for more than a week without improving with a change in diet; Right from the time of birth, the child has symptoms of constipation and abdominal distension; Constipation affects the health of children such as poor appetite, weight loss, vomiting, malnutrition,...
In addition, parents should also supplement necessary micronutrients for children such as: Selenium, Chromium , Vitamins B1 and B6, Ginger, acerola fruit extract (vitamin C),... Especially the biological zinc to improve taste, help children eat well, reach the correct height and weight and exceed the standard. , good immune system, enhance resistance to less minor illnesses, and at the same time limit constipation for children.
For more nutritional knowledge and child care for each age, parents should regularly visit the website vimec.com and make an appointment with the leading doctors, pediatric and nutrition experts of the National General Hospital. Vinmec when needing advice on children's health.