Pediatric Intestinal Obstruction
Intestinal obstruction occurs when there is an obstruction in the intestine or outside the intestine that prevents the passage of intestinal contents. There are two main causes of intestinal obstruction. One is called mechanical intestinal obstruction, which is often caused by factors such as intestinal blockage, intestinal stenosis, intestinal adhesion, intestinal tumor, intussusception, and intestinal volvulus. The other is called functional intestinal obstruction, which is often caused by factors such as indigestion, enteritis, peritonitis, pneumonia, sepsis, and abdominal surgery leading to intestinal paralysis. After intestinal obstruction occurs, due to the blockage of intestinal contents and the disruption of intestinal peristalsis, children may experience symptoms such as abdominal pain, vomiting, cessation of bowel movements and passing gas, and abdominal distension. As the condition progresses, these symptoms gradually worsen, and abdominal X-rays and fluoroscopy may reveal abnormal signs such as intestinal gas distention and air-fluid levels.
Simultaneously, due to the large amount of fluid seeping into the intestinal lumen, vomiting of a large amount of gastric and intestinal fluid, and toxin absorption, children may experience a series of systemic changes such as dehydration, acidosis, mental lethargy, irritability or drowsiness, and fever. If intestinal ischemia, necrosis, or intestinal perforation occur, it can be life-threatening.
Once intestinal obstruction occurs, it is important to go to the hospital in a timely manner to determine the cause of the obstruction and receive prompt treatment. Although chronic intestinal obstruction progresses more slowly, it still requires early treatment.
In traditional Chinese medicine, any factor that causes dysfunction of the large intestine's descending function, obstruction of qi and blood circulation in the intestines, or reverse flow can lead to this condition. Clinical manifestations include abdominal pain, abdominal distension, vomiting, absence of bowel movements, absence of rectal gas, and often accompanied by symptoms such as mental fatigue, pale complexion, and fever. The causes of this condition are numerous and complex. Here, we will only discuss massage treatments for intestinal obstruction caused by ascaris lumbricoides and fecal impaction, which are more effective.
Massage Method 1
1. Common Techniques
(1) The child lies supine, and the parent uses their thumb to rub the Zhongwan, Tian Shu, Zu San Li, and San Yin Jiao acupoints for 1 minute each.
(2) The child lies prone, and the parent massages the Pi Yu, Wei Yu, and Da Chang Yu acupoints for 1 minute each.
(3) Use the base of the palm to push down on the seven lumbar vertebrae 500 times.
2. Modifications according to symptoms
(1) Ascariasis-induced intestinal obstruction: Severe intermittent abdominal pain, accompanied by vomiting, may expel ascaris, constipation, slight abdominal distension, and a palpable soft mass that can change shape and position when manipulated. Common techniques plus: (a) Rub the navel in a clockwise direction for 5 minutes. (b) The parent uses both hands to exert force with the entire palm and uses a rotating rubbing motion to massage the ascending colon, transverse colon, and descending colon from right to left, alternating and repeating the process until the ascaris mass disappears and the pain is relieved.
(2) Fecal impaction-induced intestinal obstruction: Symptoms include abdominal distension and pain, acid reflux, difficult and infrequent bowel movements, and a palpable fecal mass. This condition is often seen in post-abdominal surgery patients. Common techniques plus: (a) Clear the large intestine and retreat the six fu organs 500 times. (b) Press the abdominal yin and yang points 5 times and push 20 times.
Massage Method 2
1. Common Techniques
(1) The child lies prone, and the parent places their middle finger on the Governing Vessel, while the index finger and ring finger rest on the bilateral back shu points. Apply pressure from the fingertips, exerting force from the acupoints towards the Dazhui acupoint, and repeat this process 5 times.
(2) The child lies prone, and the parent pinches the spine 5-10 times.
(3) Massage the Pi Yu, Wei Yu, Da Chang Yu, and San Jiao Yu acupoints for 1 minute each. Then, use the thumb, index finger, and middle finger to knead the muscles at the aforementioned acupoints 3-5 times each.
(4) Push down on the seven lumbar vertebrae 300 times and rub the turtle tail for 1 minute.
2. Lifestyle Adjustment
(1) This condition has a sudden onset and rapid changes. Before performing the massage, it is important to have a detailed understanding of the condition and make an accurate judgment. Once there is a change in the condition, immediate medical treatment should be sought to avoid worsening the condition.
(2) If the child experiences severe abdominal pain during the massage, analgesic techniques such as pressing the back shu points (pressing on areas with obvious tenderness) can be used to relieve the pain before proceeding with other techniques.
Home Emergency Measures
After pediatric intestinal obstruction occurs, do not blindly feed the child. The child should first abstain from drinking water to reduce abdominal distension. The child's position should be semi-reclined, and the condition should be closely monitored. Treatment should be conducted under the guidance of a doctor.
If the obstruction is caused by adhesions, during the recovery period, avoid eating hard foods and focus on a semi-fluid diet. If the obstruction is caused by ascaris lumbricoides, anthelmintic treatment should be administered after the symptoms subside.
Precautions
1. Regardless of the cause of the intestinal obstruction, do not give the child water or food. Pay attention to the child's abdominal pain, vomiting, and bowel movements. If the child experiences severe abdominal pain or increasing abdominal distension, or shows irritability and rapid pulse, it indicates a worsening condition and immediate medical treatment should be sought.
2. After the child undergoes surgery and returns home, pay attention to the diet and avoid consuming raw or cold foods such as raw sweet potatoes, peanuts, and beans to prevent recurrence of obstruction due to stomach and intestinal irritation.
3. Pay attention to keeping the child warm and avoid catching a cold.
