Try biofeedback therapy for children with severe constipation.

　　Children’s constipation is caused by the change of defecation law. Parents must be vigilant when children have such phenomena as obvious reduction of defecation frequency, dry stool, secret knot and irregular defecation. So, what should I do if I encounter constipation in children? March 28th is "Constipation Day in China", and the gastroenterologist introduced an effective conditioning method to parents.

　　"Belly up, hey, belly up, belly up, ok, have a rest."

　　In the gastroenterology ward of the Capital Institute of Pediatrics, Li Xiao, the nurse in charge, held Xiaoman (a pseudonym) in one hand and touched his stomach in the other. Five-year-old Xiaoman sat on the pony barrel, staring intently at two flying ponies on the display screen, while listening to the password of the nurse’s sister, trying to control the anal muscles and let the two little flying horses eat rainbow candy according to the prescribed route.

　　The "game" of Xiaoman experience is a new constipation treatment project — — Biofeedback therapy.

　　Biofeedback therapy is a non-invasive therapy, especially suitable for constipation patients, patients with fecal incontinence and children with sensory dysfunction in defecation. It avoids surgery, is painless, safe and reliable, and will not cause complications and sequelae. From the current clinical point of view, the treatment effect of children over 8 years old is more significant.

　　Constipation is a common symptom of digestive system, and it is a long-term and persistent gastrointestinal dysfunction, which can start in the neonatal period and may last until adulthood. Children’s constipation is mostly functional constipation, which is mainly caused by poor coordination and coordination of abdominal muscles, pelvic floor muscles and sphincter during defecation. It is often manifested as reduced defecation times, no defecation, dry and hard feces, difficulty in defecation, fecal incontinence and other symptoms.

　　Normal defecation is the increase of intra-abdominal pressure and intra-rectal pressure, the relaxation of puborectal muscle and external anal sphincter, so that the stool is discharged. However, when the children with poor pelvic floor coordination defecate, the pelvic floor muscles contract abnormally, and the puborectal muscles and external anal sphincter do not relax, that is, the abdominal muscles and pelvic floor muscles move in contradiction, which leads to the inability to discharge feces.

　　Generally speaking, the treatment of functional constipation includes basic treatment, toilet training, drug treatment, traditional Chinese medicine treatment, psychological behavior treatment, biofeedback treatment and surgical treatment. As a new and effective treatment method, biofeedback therapy transforms some physiological and pathophysiological activities (such as defecation process) that we can’t perceive by ourselves into perceivable forms (such as cartoon images), so that children can realize their wrong behavior and consciously adjust and control their abnormal physiological activities under the guidance of doctors. Through repeated training, they can achieve the purpose of treating constipation and establish normal physiology.

　　During the treatment of children, it is necessary to stick three monitoring electrodes on the body, including two in the muscles on both sides of the anus and one on the outside of the thigh. A manometric catheter with a balloon at the front end is inserted into the anus, so that the children can simulate defecation and observe the pressure change. Children can see the activity of anorectal muscles during defecation through the display screen, adjust themselves according to the "game" signal, relax pelvic floor muscles and external anal sphincter, and feel the correct defecation feeling of rising rectal pressure and falling anal canal pressure. 2-5 times a week, 30-40 minutes each time, 6-8 times as a course of treatment. After returning home, practice according to the correct movements and develop good defecation habits. Generally, after several courses of intermittent treatment, the defecation of children can basically return to normal.

　　Text/Qiu Shuang Ning Huijuan (Capital Institute of Pediatrics)