Intestinal disorders (constipation)

Constipation and urination disorders in children THE RELATIONSHIP BETWEEN

What is constipation?

Simply put, constipation is the infrequent and difficult defecation of solid stools. Although the concept of rarity varies from person to person, in general, it is considered normal for children to have one defecation every other day and twice a day.

The number of defecations per day may be higher in infants, especially those who receive breast milk. Constipation is one of the most common disorders in infancy and childhood. There can be many reasons from eating habits to drugs used.

Although constipation is very common in children, it is a condition that is overlooked by parents. It is common to consult a physician with complaints of abdominal pain, loss of appetite, growth retardation, difficulty in stool, painful defecation (stool), hard stool, pain or bleeding in the buttocks.

Why does constipation develop in a child?

Most children have no underlying cause. In general, after a painful poop, the child delays pooping, thinking that it will hurt every time he poops. In each delay, the last part of the intestine (rectum) where the poop is collected begins to expand by adapting to this situation, and the feeling of pooping decreases in the child. As this feeling begins to subside, the newly formed poop begins to accumulate even more in the rectum and the rectum begins to expand. This situation, which develops in a vicious circle, causes constipation to enter into advanced stages, and poop incontinence begins over time.

When is constipation most common?

Constipation is a chronic (long-lasting) process that can be seen in all age groups, although it is common in infants during the transition from breast milk to supplementary food and after toilet training between the ages of 2-4.

Can constipation and voiding disorder occur together?

There is a close relationship between voiding disorders and chronic functional constipation. When the complaints of patients who applied to pediatric surgeons with constipation are examined, it is seen that voiding disorders accompany the picture. In most of the constipated patients; The large intestine, which is constantly filled with stool, can compress the bladder and impair the filling and emptying functions of the bladder. It is clinically known to cause symptoms such as urinary incontinence, sudden urge to urinate, and urinary tract infections in children.

What kind of clinical work do we encounter in the coexistence of constipation and voiding disorder?

Chronic functional constipation and voiding disorders have a close relationship in each other’s etiology (cause-cause). If the patient has two clinical complaints, a long treatment process is required. The presenting complaints in patients with voiding disorder are daytime urinary incontinence, sudden urgency, frequent urination in small amounts, bedwetting, and urinary tract infection. About 90% of children with voiding disorders also have chronic functional constipation.

How is Constipation Diagnosed?

USG is sufficient for the differential diagnosis of anamnesis, physical examination, and direct X-ray.

If constipation is treated, will voiding disorders also improve?

There are studies in the literature showing that the treatment of chronic functional constipation improves voiding disorders. For example; patients with chronic constipation and encopresis (fecal incontinence) were re-evaluated after 12 months of constipation treatment, and it was observed that 89% of the patients who were successful in the treatment of chronic constipation improved their daytime voiding dysfunction and 63% of them at night.

How and who can treat my child with constipation and voiding disorder?

Physicians who are experts in the physiopathology of the gastrointestinal (gastrointestinal) and urinary (excretion) systems are recommended to treat these patients. Pediatric surgeons are among the physician groups that receive good training in this regard.

The doctor gave medication to my child who has constipation and voiding disorder. Will this treatment be sufficient?

Medication given may temporarily relieve symptoms. Since existing problems arise as a result of a wrongly learned behavior disorder, nutritional problem and also a chronic (ongoing) process, the duration of treatment and follow-up varies between 3 months and 1 year. In addition to drug therapy, the patient must be given proper toilet training. in children; It should be aimed to make the toilet need at least once a day in a painless manner without difficulty.

Conclusion

It is important to know that if constipation is not treated correctly in childhood, it can lead to lifelong intestinal and urinary problems. Therefore, for the health of the intestines and urinary system, it should be ensured that our children do not become constipated and go to the toilet regularly.

Private Genesis Hospital

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