Dolihosigma in children

The problem of constipation in children at an early age worries parents and pediatricians. Kids aimlessly stiffen, cry from pain and swollen abdomen, refuse to eat. Most often they are caused by a child's nutrition.

But with a constant tendency to stool delay, there is a suspicion of a pathology of the large intestine. Dolihosigma in children is a disease caused by too long a sigmoid colon. At the same time, the thickness of the walls remains normal, so the diameter of the lumen can change only when twisting, bending "unnecessary" moving loops.

Mechanism of formation of

Doctors believe that the anomaly of the long sigmoid intestine is quite common in children. It is found in 25% of newborns. In most cases, the child does not feel pathology, so it is recognized as an individual physiological abnormality.

Pathological dolhohsigmoy changes in the intestine are considered when there are violations in the formation of stool and motor function to deliver them to the anus. Up to 30% of cases are recognized as congenital anomalies in the formation of the intestinal tube of the fetus. The rest can arise in the child in the acquired order due to impaired digestion, putrefaction in the sigmoid colon, its stretching with gases and calves, the formation of new loops.

Not all pediatricians agree with this interpretation. Some believe that in childhood there can not be enough reason for the acquired disease. Pathology exists from birth, but not immediately manifested. It is provoked by improper feeding of the nursing mother and baby, lack of sufficient care for the child.

The main causes of the occurrence of

It is not yet possible to pinpoint the cause of the occurrence of dolichosigma in children. Predisposing factors and conditions of the disease were studied. These include:

• a complicated pregnancy of a prospective mother;
• effect on the fetus of infectious diseases transferred by a pregnant woman, toxic medicines;
• deficiency in vitamins and protein products in the mother's diet;
• effect on the fetus of environmental conditions( gas contamination, increased radiation, poor-quality composition of drinking water);
• Dysfunctional heredity.

How do the symptoms manifest?

Symptomatic of the disease develops in the child gradually. How pronounced manifestations depend on the degree of lengthening of the intestine, the ability of the body to compensate for peristalsis at the expense of other sites. In 2/3 cases, children under one year are affected. The main symptom is constipation. They appear when switching to lure, stop breastfeeding. They are provoked by a change in the composition of feces, an increase in volume.

In 30% of children, defecation disorders occur between the ages of 3-6.Gradually, the child becomes a problem of cleansing the bowel, the chair does not happen for 3-4 days. In addition, there are observed:

• abdominal pain, the kid react sharply to the palpation of the ileum region to the left and closer to the navel;
• bloating due to accumulated gases in the intestine;
• increase in hardness of stool consistency, relatively large diameter of excreta;
• blood admixtures due to damage to stony masses of vessels of the intestinal mucosa;
• smell from the mouth of the child;
• signs of a lack of vitamins( brittle nails, jam at the corners of the mouth);
• anemia( anemia), pallor of the skin, cyanosis of the lips.

Older children complain of increased fatigue, palpitations, refuse to eat, move games, and gain weight poorly. It is possible to attach inflammatory diseases of the stomach( gastritis) with nausea, vomiting, lesion of the biliary system, pancreas.

Dolichosigma of the intestine in the child causes imbalance in the microflora of the large intestine. It is the loss of healthy bacteria that contributes to avitaminosis. Children are prone to irritability, tearfulness, often suffer from cold diseases. Reduction of local immunity is accompanied by cutaneous manifestations in the form of small abscesses.

The course of the disease

The development of dolichosigma in the child goes through 3 stages. Some pediatricians call them forms. They differ in the severity of symptoms, the response to medical activities.

• I( stage of compensation) - the easiest, the child's constipation is unstable, hold for 2-3 days, the pain is mild, disappear after defecation. The general condition is good, the activity and development of the baby do not suffer. It can be easily treated with a diet and mild laxatives.
• II( stage of subcompensation) - constipation becomes habitual, the stool is absent for more than three days. There is bloating, pain syndrome. The child is irritable, does not eat well, lags behind in weight. To cleanse the intestines, you have to use enemas, diet and laxatives are not enough.
• III( stage of decompensation) - the picture of the disease is pronounced, the symptoms are started. The child suffers from prolonged constipation, there are signs of intoxication( headaches, lethargy, nausea, vomiting), anemia and vitamin deficiency. Pain in the abdomen and bloating are kept constantly. There are attacks of partial obstruction of the intestine. Cleanse the intestines of the baby is helped only by siphon enemas. Such a condition can be effectively treated only by a surgical method.

What methods of diagnosing dolichosigma are used in children's practice?

The doctor carefully holds a finger examination of the rectum. With constipation caused by dolichosigma, it is empty. Palpation of the abdomen indicates a lesion in the descending zone of the large intestine. Sometimes it is possible to feel through the thin abdominal wall of the child hard stool stones.

Diagnostic tests of blood, urine and feces in this case are not determinative. But they are necessary for detection of complications, adherence of inflammation of the intestine, urinary organs, diseases.

Therefore, the following is mandatory:

• blood test( leukocytosis, increased ESR, hemoglobin level, erythrocyte counts);
• feces( mucus, latent and obvious blood, purulent impurities, white blood cells, undigested particles), checked for parasitic infection;
• in the urine there may be signs indicating the passage of inflammation from the intestine( mucus, leukocytosis, bacteria, erythrocytes).

The elongation of sigma in young children can be detected only with the help of irrigography after the introduction of an enema with barium suspension. For older children, barium is taken in solution with a subsequent series of pictures of the stomach and intestines.

ultrasound allows considering gut full of intact feces. Computer tomography in childhood is impossible, because it requires a patient's calm motionless state. If a differential diagnosis is necessary under short anesthesia, a colonoscopy is performed using a thin baby probe. Introduction through the rectum provides an opportunity to examine the large intestine, to assess the damage to the mucosa

Conservative treatment of

At any stage of the disease, treatment begins with therapeutic methods. Only in the absence of results is the question of indications for surgical intervention solved.

Recommendations for nutrition

The nature of nutrition is important in therapy. For this, parents need to remember some rules. To the kid it is useful to drink much water, better slightly acidified with lemon juice. The liquid makes it possible to soften the stool masses. Categorically forbidden any carbonated drinks, kvass. They help glue the feces into lumps.

Well acting mineral water with released gas and in a warm state. It is necessary to choose those that contain sulfate salts. How much water to drink to a specific patient will tell the doctor. Feeding is done in small portions, at least six times a day. You need to cook only boiled, steamed. Everything that is covered with crusts, fried, sharp, smoked is forbidden.

Rations are excluded from the diet, making it difficult to pass food through the intestines:

• cereals( rice, semolina, millet);
• flour products( pasta, fresh pastries, cakes, cookies);
• meat dishes and animal fats( intensify the processes of fermentation, "get stuck" in the intestines, poorly digested);
• sweets( sweets, chocolate);
• strong tea, cocoa, coffee.

You can feed the baby:

• boiled fish and soups from it;
• curd;
• kefir, yoghurt;
• with buckwheat porridge;
• with vegetable dishes( vegetarian soup, hodgepodge, salads);
• used vegetable oils( olive, sunflower, flaxseed) for refueling.

Addition of bran is recommended. Vegetables and fruits containing a lot of fiber are useful. It helps to relax the stool( boiled carrots and beets, pumpkin, apples, plums, prunes, dried apricots, apricots).They are used in salads, juices, bake in the oven for a mid-morning snack, prepare a decoction or compote. From sweets, you can have a little honey, marmalade( contains pectins).It is not recommended to add food to the food: bananas, pears, grapes.

Drug treatment

In connection with the violation of the production of their own vitamins in the intestine, the child is shown vitamin complexes, including vitamins C, A, E, group B, D. They will help prevent the development of anemia, decreased immunity.

The doctor determines whether a small patient needs antispasmodics, because the pains are caused not by spasm, but by stretching and atony. The uncontrolled reception of No-shpa, Drotaverina only worsens the situation. It is very important to restore the intestinal flora, so prescribe repeated courses of probiotics such as Bifidumbacterin, Lactobacterin, dairy products with bacteria for the intestines.

does not help. In the treatment of children, Dufalac, Mukofalk, Duspatalin, Festal are used. The drugs have the ability to increase the tone of the intestinal wall, dilute fecal masses, strengthen muscle motor.

Methods of physiotherapy

For physiotherapeutic treatment are effective:

• electrostimulation of the intestine;
• laser exposure;
• acupuncture;
• electrophoresis with tonic substances.

Very careful attitude has developed to hydrocolonotherapy( washing the intestine with mineral waters, herbal decoctions).They try not to assign it even to adult patients due to a large number of complications.

Cleanses

The introduction of water or saline with an enema has a local irritant effect on the rectum. Reflexively, a urge to defecate. The volume of water for the enema is determined by the age of the child. The toddler is put on the right side, the buttock is raised and the enema tip, lubricated with petroleum jelly, is injected.

The solution should not differ from the body in temperature. Too hot or cold is painfully tolerated by the child. After the introduction you need to squeeze the buttocks and sit or abuse the baby in your arms for 10-15 minutes. Then put on a pot.

Massage

The only contraindication to the massage is the presence of blood in the stool and an unclear source of bleeding. Breasts need a daily massage of the back and abdomen to strengthen the muscles. In the position on the abdomen, two fingers make spiral movements along the vertebral zone from the waist to the coccyx. Thus, it is possible to stimulate the call of a urge to defecate.

The abdomen is massaged in a circular motion clockwise. It is necessary that the massage was pleasant to the child. You can not allow shouts, sharp pressure. The beginning of the procedure is always performed by stroking and rubbing the skin. Then proceed to soft slow pressing movements. In the reverse order, tapping with phalanxes of fingers is completed. The whole procedure takes 20 minutes.

Therapeutic physical training

Indicated for older children. It is better to take the child to the group classes at the clinic. Here they look at each other and learn the exercises faster. To stimulate the work of the intestine are shown:

• running;
• jumping in place;
• movement, strengthening the abdominal muscles;
• wrapping of the hoop.

Folk remedies

The recommendations of traditional medicine help in complex conservative action. The possibility of using it is necessary to speak with the pediatrician, since at different ages there may be contraindications.

Among the herbal remedies, it is proposed to use:

• syrup from celandine - the same amount of celandine grass and sugar after mixing is tied in a gauze knot and placed for 2 weeks in dairy whey;
• vegetable oil( preferably linseed or sunflower) - given before meals on a teaspoon, it is necessary to provide preliminary sterilization by boiling in a bottle in a water bath;
• the combination of buckthorn and prunes in the broth improves the taste, the child is useful as a compote after dinner;
• from flax seeds prepare water infusion( 1:30) for an hour, filter and drink on an empty stomach, can be crushed in a coffee grinder and give to the child in the form of a powder of ½ teaspoon;
• , wheat sprouts should be added to salads and cereal;
• cabbage juice is prepared fresh, it is recommended to spend 2 weeks.

Surgical treatment

Indication is the lack of the child's results from the diet, medication, massage, accustomed to enemas, marked signs of intoxication. The operation is performed under general anesthesia. The surgeon cuts off unnecessary loops of the sigmoid colon, sews the lower and upper ends.

If suspected of obstruction, the child is operated according to vital indications. The doctor should examine the entire intestine for tissue viability. Twisting of the moving loops can squeeze and disrupt the feeding of the intestinal wall leading to necrosis. Then, except for the sigmoid region, it is necessary to delete other parts.

What are the complications of untreated dolichosigma?

At inattentive attitude to attributes of illness at the child arise:

• backlog in physical development, exhaustion;
• anemia;
• pustular rashes on the skin;
• stool stones that can cause intestinal obstruction;
• chronic poisoning with slag - a toxic intoxication.

Frivolous attitude to the course of pregnancy, constipation of the child born, lack of due care of the adults contributes to the appearance of the child dolichosigma and severe consequences. Treatment in the advanced stage, refusal of timely examination lead to the need for an operative method of treatment. The earlier to reveal the disease in the baby, the more guarantees of its complete cure.