Dr. Mohammed Salauddin1, Dr. Sandhya Rathour2, Dr. Shivangi Jain2, Dr. Manju Bijarnia2
1. HOD, Department of Anatomy, Homoeopathy University, Jaipur (Raj.)
2. PG scholar Department of Paediatrics, Dr. M.P.K. Homoeopathic Medical College Hospital and Research Centre, Jaipur (Raj.)
ABSTRACT: Constipation is a common problem pediatrician seen in their clinic. 95% children are suffers from functional constipation. Main aim of the pediatrician is to treat the constipation in early stage with the help of homoeopathy we can improve the functioning of the gastrointestinal system.
KEYNOTE: Functional constipation, Homoeopathy, Children, Stress.
INTRODUCTION: Most commonly children are constipated during starting of school going age. Constipation defines as a less than 3 stool in a week, or difficulty in passing stool hard stool in present, then children is considered as constipation. According to Rome III chronic constipation symptoms must include at least 2 symptoms of the following: 1) Two or fewer defecation per week. 2) At least 1 episode of fecal incontinence per week in toilet trained child. 3) History of excessive stool retention. 4) History of painful or hard bowel movement. 5) Presence of large fecal mass in the rectum. 6) History of large diameter stool that may obstruct the toilet.
This is very common problem in pediatric age group, in children normal stool frequency decrease 3-4 times during per day during infancy and once per day during 4 year of age. Red flag’s failure to thrive blood in stool, lump in abdomen, recurrent vomiting, recurrent infection complain should alert the physician to suspect organic etiology.
Causes: Hischsprung disease, pseudo obstruction, rectal stricture, anal stenosis, pelvic mass, hypothyroidism, celiac disease. Hypercalcemia, IBS, diabetes mellitus, mental retardation, autism, stress, drugs.
History taking of the children about their their dietary habit, fibers intake, proper asking about water intake quantity of the child, stool pattern toilet habbit should be asked or any previous drug history if taken. Ask to the parents about stress of eduction behavior of the child with others, detailed about the physical activity of the child should be asked.
Investigation:
• Rectal Biopsy
• Anorectal Monometry
• MRI of Lumbosacral region
• Colonic Transit Study
• Metabolic, endocrine & other tests (Such as Hypothyroidism, Diabetes Mellitus, Hyper Calcemia etc.)
Management:
• Diet, Fluids, Exercise & Toilet Training: In constipation fiber diet is advice to the child such as Sprouts, Pulses, Green Vegetables, fruits. Advise adequate amount of water to drink to avoid dryness of the rectum. Regular exercise should be advised.
• Behavior Therapy: Regular training of the setting on toilet to passing stool after every meal give positive impacts. Punishment should be avoided
• Pharmaco Therapy: Laxatives should be given as lubricants, stimulants for passing stool.
• Dismpaction: It is requires for rectal impaction is responsible for progressive delation of rectum for defecation this clear out is essential for effectiveness therapy.
• Counseling: Discuss the parents about children behavior if there is any stress or fear to overcome not to blame child for spoiling meet with teachers and teal about the problems and take proper medication for constipation.
• Maintenance Preventions of Reimpaction: The aim of maintenance therapy is for regular stooling habit and prevent reimpaction.
HOMOEOPATHIC MANAGEMENT:
1. Collinsonia – Obstinate constipation with haemorrhoids; stools very sluggish and hard, accompanied by pain and flatulence. Hard, lumpy, knotty stools. Light dry balls. Bowels not moved for days, constant pressure in rectum with a heavy dragging ache in pelvis. Constipation of children from intestinal atony. Alternate constipation and diarrhœa, and great flatulence.
2. Chionanthus virginica -Clay-colored stool, also soft, yellow and pasty. Stools undigested and showing an absence of bile. First part of stool watery, but last more solid in appearance, 10.30 a.m. Stools terribly offensive, like carrion.
3. Euonymus atropurpurea -Constipation with hæmorrhoids and severe backache. Bilious headache; coated tongue, bad taste, constipation. Flatus and pain. Mouth dry, pasty taste; thirsty, stomach full and uncomfortable.
4. Guaiacum – Pinching in the abdomen, as from incarceration of flatus. In constipation the stool is hard, dry, crumbling, and very offensive.
5. Iris versicolor – Constipation several days. Stools costive, and absent altogether for two days. Tools lumpy, brown, and very offensive .Very hard, lumpy stool
6. Paraffinum -Obstinate constipation in children. Bowels confined for two days and very hard; evacuation in small pieces. Frequent desire for stool without result. Stools hard but occurring every day. After going for three days without stool he is obliged to remain an hour before expelling anything, and becomes very much fatigued.
7. Solanum nigrum -Constipation, small, dry, hard stools. Stools: natural but more frequent; semi-fluid; yellow, watery. Appetite lost. Great thirst, for large quantities, often.
8. Terebinthiniae oleum- Constipation, with distension of abdomen. Ineffectual urging. Tenesmus, bloody stools. Hard, scanty fæces. Dry, brown evacuations. Fæces of the consistency of pap, with pinchings in abdomen, and burning sensation in rectum and anus (after stool).
CONCLUSION & DISCUSSION: Constipation is a common problem in children. When change in their food intake from liquid to solid at the age of 2 years. Most of the children complain of constipation at this age. Child also start schooling at the age of 2.5 – 3 years of the age. There is also change in environment by using homoeopathic medicine with proper dietary measures. We can easily cures the constipation. It will also helps healthy metabolic activity of the children and promote good health and hygiene.
BIBLIOGRAPHY:
1. Paul VK, Bagga A. Ghai Essential Pediatrics. 8th ed. New Delhi: CBS publisher & distribution Pvt. Ltd. 2009.
2. Parthasarathy A. IAP Text Book of Pediatrics. 6th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2016.
3. Goel K, Gupta D. Hutchison’s Paediatrics. 2nd ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2012.
4. Boericke W, Boericke OE. Pocket Manual of Homoeopathic Materia Medica & Repertory comprising of the characteristics and guiding symptoms of all remedies. New York: Boericke & Runyon; 2007.
5. Allen HC. Keynotes and Characteristics with comparisons of some of the leading remedies of Materia Medica. New Delhi: Indian Books and Periodicals publishers, 10th edition.
