Valenta presented modern methods of treating children for constipations, and its own expertise in the field of this disease therapy at ‘Matching Incongruities — Oxymorons in Pediatrics’ symposium
Normal functioning of the large intestine is traditionally considered to be one of the indicators of children’s health. Parents worry if their infant’s bowel regularity gets out of its natural rhythm.
Constipation is an integrated set of different symptoms connected with persistent disorders of intestinal evacuation (stool is poor and thick and comes less than 3 times a week). When gastrointestinal tract functions normally, frequency of defecation in infants of the first 3 months of life is 5-7 times a day (breast feeding), and it is 1-2 times a day in infants over 3 months of age. Stool color depends on the diet. Constipation is one of the most widespread problems in children of all ages — 3-5% of children who addressed general practitioners and more than 25% of those who addressed children’s gastroenterologists had these problems. 10% of newborns and the overwhelming majority (90%) of infants in their first year of life have functional constipations, which could be regarded as a manifestation of vegetative visceral syndrome of CNS perinatal impairments1.
Functional constipation in children is characterized by thick stool at most of defecation acts (2/less than 1 time a week) and absence of organic, structural, metabolic or endocrinal disorders. The main causes of functional constipations in children of the first year of life are early and/or too fast baby transfer to artificial feeding; mother’s wrong daily routine or diet; non-observance of drinking intake or feeding regime by mother or child; intolerance of cow-milk protein; iron deficiency. Besides, the disease can be caused by a genetic predisposition, pathological course of pregnancy and labor; perinatal impairments of CNS; muscular hypotonia; prematurity; hypothyroidism; D hypervitaminosis; food allergy; intestinal dysbiosis; mother’s insufficient attention to duly development of the child’s defecation reflex, etc.
Presence of stool after anus irritation or green color of stool are among risk factors of developing constipation for a child in the first year of life; and between 2 and 3 years of life — independent defecation 1 time in 2-3 days. Constipations in children cause the increase the intra-intestinal pressure inducing pain syndrome and pressure increase in the large intestine disrupting evacuation from the small intestine, duodenum and stomach; it can change normal structure of intestinal microflora, inducing excessive bacterial growth and accumulation of protein decomposition products in the intestine, which increases functional load on liver causing the development of fatty hepatocytes dystrophy; growth of risk of allergic pathology; intoxication (appetite disturbances, depressed mood, irritability, etc.).
The main principles of treating children for constipations are the following: diet with inclusion of fiber and appropriate water balance, sufficient physical activity, belly massage, laxative medicines, normalization of intestinal microflora, and correction of GI motility. Besides, the patient’s nutrition diary is very important, including consumption of liquid, motor activity and defecation. The basic effectiveness criteria of the therapy applied for patient’s treatment for constipation is restoration of regular bowel movement, correction of disturbed functions of the large intestine and digestive tract in general, management of subjective symptoms and improvement of the patient’s quality of life.
A.V. Gorelov, MD, Professor at the Department of Child Diseases of I.M. Sechenov First Moscow State Medical University, Board Vice President of the Moscow Society of Paediatrician: «Constipation in children is a serious disease, which, in the absence of due treatment, can cause complications in the advanced age. Against the background of children’s constipations, normal intestinal microflora is often disturbed. The problem of constipations needs comprehensive medicine — besides removing constipation, it has to feature prebiotic action. Today, Valenta produces a medicine for all stages of constipation pathogenesis. This is an osmotic and laxative medicine Exportal® (Lactilol). Clinical trials of the therapy for constipations have proved its efficacy and safety. Besides, against the background of Exportal® therapy, intestinal microflora is normalized, since the medicine stimulates proliferation of lacto bacteria and bifidus bacteria».
- 1 G.V. Yatsyk. Guide for Neonatology. M.: MIA, 1998, p. 397, I.A. Belyaeva. Medication and Dietary Correction of Intestinal Disorders in Infants