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Seyrek Dışkılayan Bebeklere Nadiren Tedavi Gerekir

Yıl 2018, Cilt: 12 Sayı: 3, 186 - 192, 01.12.2018

Öz

Amaç: Seyrek dışkılama (SD) günlerce gecikmiş, fakat normal kıvam ve renkteki dışkılamayı tarif eder. Literatürde altı aydan küçük olup, anne sütü ile beslenen bebek ve çocuklarda seyrek dışkılama ile ilgili çok az bilgi vardır. Çalışmada, SD’sı olan bebeklerin bulgu ve semptomları ele alınarak, SD’nın seyrinin, ne kadar devam ettiğinin, yapılan tedavilerin etkinliğinin, tedavi gereksinimlerinin tartışılması, doğru yaklaşımın nasıl olması gerektiğinin saptanması amaçlandı.Gereç ve Yöntemler: Çalışmaya, polikliniğimize 2 gün ve üzeri kaka yapmama şikayeti ile getirilen 6 aydan küçük yenidoğan ve süt çocukları dahil edilmiştir. Sadece anne sütü ile beslenen, kilo alımı iyi olan, mekonyumunu zamanında çıkarmış, sert dışkılaması, karın şişliği ve anal bölge sorunları olmayan çocukların bilgileri geriye dönük incelendi. Takiplerinde fiziki muayeneleri yapılmış, beslenme durumları sorgulanmış, büyüme eğrisi kaydı tutulmuştur. Ayrıca seyrek dışkılaması nedeni ile yapılan tetkikler ve tedaviler irdelenmiştir.Bulgular: Çalışmaya toplam 50 bebek (ortalama yaş: 55.7 gün) dahil edildi. Ortalama doğum ağırlığı 3179±539 gr’dı. Seyrek dışkılama ilk olarak ortalama 48.52±39.21 günde (aralık: 2 gün-5.5 ay) başlamıştır. İlk seyrek dışkılamanın devam etme süresi ortalama 4.7±1.59 gün (% 95 GA: 4.2-5.2), seyrek dışkılamaların toplamının devam etme ortalaması ise 2 ay olmuştur (aralık: 2 hafta-5.5 ay, % 95 GA: 45.7-71.9). Seyrek dışkılama hastaların % 75’inde 2 ay sürmüştür. Doğum ağırlığı ile seyrek dışkılama (r=0.35) ve gebelik haftası ile seyrek dışkılama arasında (r=0.33) zayıf ilişki saptanmıştır. Yedi çocuk farklı merkezlerde tetkik edilmiş, 36 çocuğa ise ya hekimler ya da ebeveynler tarafından çeşitli tedaviler uygulanmıştır. Hiçbir hastada tıbbi tedaviye ihtiyaç duyulmamıştır.Sonuç: Sonuç olarak, çalışmaya dahil edilen tüm çocuklarda seyrek dışkılama durumu geçmiş, bu durum hiç bir hastada fonksiyonel kabızlığa dönüşmemiştir. İyi beslenen, huzurlu, yeterince kilo alan, karın şişliği ve sert dışkılaması olmayan bebek ve çocuklarda seyrek dışkılamanın geçici bir durum olduğu, tedaviye gerek olmadığı görülmüştür. Seyrek dışkılamanın kabızlıktan ayırımı yapıldıktan sonra tedavisiz takip edilmesi yeterlidir. Bu bilginin pediatristler, pediatrik cerrahlar, sahada çalışan hekim ve hemşirelere faydalı olacağı kanısındayız.

Kaynakça

  • den Hertog J, van Leengoed E, Kolk F, van den Broek L, Kramer E, Bakker EJ, et al. The defecation pattern of healthy term infants up to the age of 3 months. Arch Dis Child Fetal Neonatal Ed 2012;97:F465-70.
  • Kocaay P, Egritas O, Dalgic B. Normal defecation pattern, frequency of constipation and factors related to constipation in Turkish children 0-6 years old. Turk J Gastroenterol 2011;22:369- 75.
  • Bekkali N, Moesker FM, Van Toledo L, Reitsma JB, Hamers SL, Valerio PG, et al. Bowel habits in the first 24 months of life: preterm- versus term-born infants. J Pediatr Gastroenterol Nutr 2010;51:753-8.
  • Camurdan AD, Beyazova U, Ozkan S, Tunc VT. Defecation patterns of the infants mainly breastfed from birth till the 12th month: Prospective cohort study. Turk J Gastroenterol 2014;(25 Suppl 1):1-5.
  • A drawback of this study is that the data were collected retrospectively. This study has some limitations. First, these
  • Barness LA, Curran JJ. Nutrition. In: Berhman RE, Kliegman RM, Arvin AM (eds.) Nelson’s Textbook of Pediatrics. 15th ed. Philadelphia: WB Saunders, 1996:151-66.
  • Bullen CL, Tearle PV, Willis AT. Bifidobacteria in the intestinal tract of infants: An in-vivo study. J Med Microbiol 1976;9:325-33.
  • Weaver LT, Laker MF, Nelson R, Lucas A. Milk feeding and changes in intestinal permeability and morphology in the newborn. J Pediatr Gastroenterol Nutr 1987;6:351-8.
  • Fishman L, Rappaport L, Cousineau D, Nurko S. Early constipation and toilet training in children with encopresis. J Pediatr Gastroenterol Nutr 2002;34:385-8.
  • Rasquin-Weber A, Hyman PE, Cucchiara S, Fleisher DR, Hyams JS, Milla PJ, et al. Childhood functional gastrointestinal disorders. Gut 1999;(45 Suppl 2):1160-8.
  • Bekkali N, Hamers SL, Schipperus MR, Reitsma JB, Valerio PG, Van Toledo L. et al. Duration of meconium passage in preterm and term infants. Arch Dis Child Fetal Neonatal Ed 2008;93:F376-F9.
  • Eur J Pediatr 2004;163:630-1; discussion 632-3.
  • Sreedharan R, Liacouras CA. Major symptoms and signs of digestive tract disorders. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, Behrman RE (eds). Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:1758-67.

Infants with Infrequent Stools Rarely Require Treatment

Yıl 2018, Cilt: 12 Sayı: 3, 186 - 192, 01.12.2018

Öz

Objective: Infrequent stools (IS) refer to passage of stool that is delayed for days but has normal consistency and color. There is a paucity of information about infrequent stools in infants and children aged less than 6 months who are exclusively breastfed. Herein, we investigated the signs and symptoms of ISin order to discuss its course, duration, and need for treatment, and the efficacies of available treatments. We also aimed to determine the aspects of a clinically appropriate approach for affected patients.Material and Methods: This study included newborns and infants aged less than 6 months who presented to our outpatient clinic with a history of not having passed stools for 2 days or longer. We exclusively reviewed the medical records of infants who were exclusively breastfed, who had a decent weight gain, who had passed meconium in time, and who were free of hard stools, abdominal swelling, or anal problems. During follow-up, all infants underwent physical examination, their nutritional status was questioned and their growth charts recorded. Additionally, tests and treatments performed for infrequent stools were reviewed in detail.Results: The study included a total of 50 infants with a mean age of 55.7 days. The mean birthweight was 3179±539 gr. The mean age at onset of infrequent stools was 48.52±39.21 days (range: 2 days-5.5 months). The mean duration of the first infrequent stools was 4.7±1.59 days (95% CI: 4.2-5.2); the mean duration of infrequent stools was 2 months (range: 2 weeks-5.5 months, 95%CI: 45.7-71.9). Infrequent stools lasted for 2 months in 75% of patients. Weak correlations were found between birth weight and infrequent stools (r=0.35) and between gestational age and infrequent stools (r=0.33). Seven children were examined at other centers, and 36 children were administered various treatments either by physicians or parents. Medical treatment was not needed in any patient. Conclusion: In conclusion, infrequent stools improved in all children included by this study, and this condition did not transform into functional constipation in any of them. It was observed that infrequent stools was a transient condition requiring no treatment in infants and children who were adequately nourished, who gained adequate weight, and who were free of abdominal swelling or hard stools. It usually suffices to follow this condition conservatively after it is distinguished from constipation. We believe that this information would be useful for pediatricians, pediatric surgeons, and physicians and nurses working on the field

Kaynakça

  • den Hertog J, van Leengoed E, Kolk F, van den Broek L, Kramer E, Bakker EJ, et al. The defecation pattern of healthy term infants up to the age of 3 months. Arch Dis Child Fetal Neonatal Ed 2012;97:F465-70.
  • Kocaay P, Egritas O, Dalgic B. Normal defecation pattern, frequency of constipation and factors related to constipation in Turkish children 0-6 years old. Turk J Gastroenterol 2011;22:369- 75.
  • Bekkali N, Moesker FM, Van Toledo L, Reitsma JB, Hamers SL, Valerio PG, et al. Bowel habits in the first 24 months of life: preterm- versus term-born infants. J Pediatr Gastroenterol Nutr 2010;51:753-8.
  • Camurdan AD, Beyazova U, Ozkan S, Tunc VT. Defecation patterns of the infants mainly breastfed from birth till the 12th month: Prospective cohort study. Turk J Gastroenterol 2014;(25 Suppl 1):1-5.
  • A drawback of this study is that the data were collected retrospectively. This study has some limitations. First, these
  • Barness LA, Curran JJ. Nutrition. In: Berhman RE, Kliegman RM, Arvin AM (eds.) Nelson’s Textbook of Pediatrics. 15th ed. Philadelphia: WB Saunders, 1996:151-66.
  • Bullen CL, Tearle PV, Willis AT. Bifidobacteria in the intestinal tract of infants: An in-vivo study. J Med Microbiol 1976;9:325-33.
  • Weaver LT, Laker MF, Nelson R, Lucas A. Milk feeding and changes in intestinal permeability and morphology in the newborn. J Pediatr Gastroenterol Nutr 1987;6:351-8.
  • Fishman L, Rappaport L, Cousineau D, Nurko S. Early constipation and toilet training in children with encopresis. J Pediatr Gastroenterol Nutr 2002;34:385-8.
  • Rasquin-Weber A, Hyman PE, Cucchiara S, Fleisher DR, Hyams JS, Milla PJ, et al. Childhood functional gastrointestinal disorders. Gut 1999;(45 Suppl 2):1160-8.
  • Bekkali N, Hamers SL, Schipperus MR, Reitsma JB, Valerio PG, Van Toledo L. et al. Duration of meconium passage in preterm and term infants. Arch Dis Child Fetal Neonatal Ed 2008;93:F376-F9.
  • Eur J Pediatr 2004;163:630-1; discussion 632-3.
  • Sreedharan R, Liacouras CA. Major symptoms and signs of digestive tract disorders. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, Behrman RE (eds). Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:1758-67.
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA28ZS87EB
Bölüm Research Article
Yazarlar

Nazile Ertürk Bu kişi benim

Yayımlanma Tarihi 1 Aralık 2018
Gönderilme Tarihi 1 Aralık 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 12 Sayı: 3

Kaynak Göster

Vancouver Ertürk N. Infants with Infrequent Stools Rarely Require Treatment. Türkiye Çocuk Hast Derg. 2018;12(3):186-92.

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