Thursday, March 13, 2008

constipation of all things:)

Well, I go in spurts with writing so I apologize for any delay. I just thought I would pass on the education that I received during our noon conference lecture while we all ate lunch.

The topic was constipation and some of you may think this is a boring process, but not so with children. Constipation can be an active process for some but definitely not all children or adults.

First of all, there is the poop dance best described as a child walking on their tip toes and squeezing both of their gluteus maximus muscles together to withhold from pooping until the urge to defecate has passed. Sometimes, a child will hold onto furniture with their arms, stand on their tip toes, and stay in that position until the urge passes.

We learned that after a long stent of holding feces, there can be something that forms called a "fecolith" A.K.A. "poop rock" that sits near the rear exit and prevents passage of stool, until there is such a large build up and the anal sphincter muscle is stretched and nerve endings are stretched beyond working that stool is passed unknown to the child. This is called encoparesis.

Some of you may be wondering "why would someone try to withhold stool when it can get so bad?" Well, it could be that there was something that had made passing stool painful in the past and many other problems. The important thing is that there is treatment and it is not the fault of the child regarding constipation.

So interesting notes: I learned a very interesting term "ileal brake ". There are three parts to the small intestine: 1st- duodenum, 2nd- jejunem, 3rd- ileum. The ileum is the last place where nutrients are largely absorbed especially fat! (Interestingly about 99% of fat is absorbed from food!!) So when a person eats a meal high in fat content, the food gets to the ileum and the transit of the food slows down remarkably to increase absorption, therefore causing an "ileal brake". They recommend eating diets low in fat if constipation is a problem. They also recommend drinking plenty of fluids and once regularity isn't as large of an obstacle, high fiber foods can be implemented.

I hope you feel enlightened and to quote our speaker "have the scoop on poop"!