Constipatia este o afectiune care afecteaza inclusiv sugarii. In cazul in care acestia sunt alaptati, problema poate fi rezolvata prin alimentatia mamei.
Mai putin de 3 scaune pe saptamana si/sau cresterea consistentei lor, definesc constipatia. In cele mai multe cazuri, constipatia este o tulburare functionala si mai rar reprezinta o manifestare a unei boli organice.
La bebelusi, constipatia poate fi usor confundata sau interpretata gresit, datorita peristaltismului intestinal mai lent. Miscarile de contractie ale intestinelor, care favorizeaza eliminarea continutului, sunt mai lente datorita imaturitatii tubului digestiv la aceasta varsta. Asta face ca sugarul sa aiba scaune mai rare, consistenta lor sa fie mai crescuta, fara insa ca acest lucru sa se incadreze in definitia constipatiei. Este asa-zisa "falsa constipatie", care are acelasi tratament ca si constipatia functionala propriu-zisa.
Ulterior, constipatia poate fi determinata de factori genetici, familiali, constitutionali si favorizata de:
● sex (este mai frecventa la fetite)
● alimentatie (exces de proteine si deficit de fibre)
● igiena defecatiei (orar neregulat, mai ales in perioada de instalare a controlului sfincterian)
● factori psihologici (constipatia consecutiva unei defecatii dureroase sau retinerea de a folosi toalete cu care copilul nu este obisnuit).
Constipatia de cauza organica necesita control medical riguros si tratament specific afectiunii ce o determina. Constipatia functionala in schimb se bazeaza pe masuri dietetice.
In cazul bebelusilor alaptati, este indicata o dieta corespunzatoare mamei, mai ales ca in majoritatea cazurilor si mama sufera de aceasta dereglare a functiei digestive. Astfel mamei ii este recomandat sa manance mai multe fibre, sa evite alimentele ce pot determina cresterea consistentei scaunului (banane, orez fiert, morcov fiert, ceai de menta etc.), sa bea multe lichide si sa faca exercitiu fizic.
Se mai poate folosi fara niciun risc pentru mama care alapteaza si de asemenea fara niciun risc pentru bebelus, lactoza naturala care se gaseste in farmacie, sub forma de Humana Milchzucker. Acesta este un laxativ natural si fiziologic ce ajuta la rezolvarea constipatiei atat la mama cat si la copil, prin eliminarea unei parti in laptele matern Lactoza contribuie in mod natural la formarea scaunului, avand un efect osmotic la nivelul colonului. Adaugarea de lactoza naturala in alimentatie, determina reglarea fiziologica, naturala a constipatiei. Lactoza se poate adauga in mancare sau orice lichid. Ea poate fi administrata si bebelusului, intr-o cantitate mica de lapte muls sau ceai.
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Daca bebelusul este deja alimentatia diversificata, atunci este de preferat ca in meniul lui sa nu fie prezente in cantitate mare alimente care constipa si pe care le-am enumerat mai sus. Este indicata administrarea sucului de pere, prune, fructe crude (sortimentul administrat este in functie de varsta), cereale bogate in fibre. Si in acest caz, se poate folosi lactoza naturala administrata o singura data pe zi.
Avand o actiune naturala, fireasca, fiziologica, lactoza naturala, se poate administra pe termen lung, nu da scaune explozive, colici abdominale si nici dependenta.
Timpul scurs pana la reglarea in totalitate a scaunelor poate fi de cateva zile, o saptamana.
In nici unul din cazuri nu este indicata folosirea laxativelor. Acestea pot elimina pe moment problema constipatiei, facand insa pe cei mai multi sa devina dependenti de ele. De asemenea pot determina si pierderea contractilitatii normale a intestinelor, iritatii si chiar afectiuni cronice ale aparatului digestiv. Stimularea sfincteriana (ex: cu termometrul) poate si ea sa fie daunatoare, determinand lezarea si afectarea plexurilor nervoase de la acest nivel si contractia normala a sfincterului anal.
Ideal ar fi ca orice problema de constipatie sa fie rezolvata pe cat posibil pe cale naturala.
Dr. Oana Gheorghiu - medic specialist medicina de familie
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