Treatment of Pediatric Ileus

pediatric constipation

Pediatric Constipation

I recently had the opportunity to treat a baby at the Doernbecher Children’s Hospital, here in Portland. The baby, just 11 months old, was admitted to the hospital for surgical correction of a ruptured feed tube which caused a postoperative ileus – hypomotility of bowels without any obstruction (in English: pediatric constipation – the baby wasn’t pooping, for no apparent reason).

By the time I saw the baby it had been more than a week since the passage of any stool and the doc was considering surgery to correct the paralytic ileus. The mom wanted what was best for her baby, but was hoping to avoid surgery if it was possible. She called me with her concerns.

Diagnosis

I visited to the hospital the very next morning to see the child and offer treatment. The constipation was the primary symptom, but every ailment occurs within a system and many factors are considered in determining the best course of care.

In this case, I had to consider the reason for the surgery in the first place, which was the ruptured feed tube. The baby had been diagnosed with failure to thrive several months prior due to poor weight gain and growth. Current symptoms included a distended belly with colicky pain, poor sleep, and the baby was easily startled. Additionally there was a very rough spot on the SI channel on the left arm and greenish blue tinge between the eyes.

All signs pointed toward Japanese pediatric acupuncture diagnosis of “Kanmashishu” which refers to a child who will not settle down, is distressed, cries and screams a lot, sleeps poorly and is generally irritable. We, in the west, might call this pattern “colic.” Whatever you call it, the presentation of symptoms is important to record alongside the chief complaint. It pointed me toward a treatment that would have better results than simply treating the constipation alone.

Treatment with Pediatric Acupuncture

With my pediatric patients (and nervous adults too) I always use a very gentle form of acupuncture. No needles were inserted. I used only shonishin (non-insertive acupuncture) methods of stroking, tapping and pressing the skin and acupoints at very specific locations on the body to address the root of the kanmashishu.

Even though I have seen, time and again, the power of these gentle treatments (see my recent post on treating childhood night terrors), I knew how worried the mother was for her baby, and I couldn’t help but worry if it would be enough.

My answer came early the next morning via text message from the mother: the infant had had several bowel movements the night before and then again in the morning.

Anecdotal? Coincidental? Possibly. As a practitioner with a strong background in western medical science, I have to conceded that this one case hardly constitutes scientific evidence. But the potential risk was next to nothing, and the possible benefits were high. That is a risk-return ratio that anyone can support.

Although out of the danger zone as a candidate for surgery, the pattern of kanmashishu remains. It is a tricky pattern that can persist and needs a course of treatment over time. Acupuncture can have amazing affects, but there are no miracle cures. Our best course of action is to address the underlying imbalances and stressors, working with the infant’s pediatrician, so that the longstanding illness can be healed.

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