Clinical features and outcome of fecal retention in infancy

Abstract

1) Background: To understand the clinical features and outcome of fecal retention in infancy(FRI), so as to guide the focus and intervention methods of such infants.2) Methods: The electronic medical record system(EMRS)was used to collect and screen out cases diagnosed as fecal retention from June 2018 to June 2019 in outpatient clinic of our hospital. The age, feeding method, frequency and traits of stool, and accompanying symptoms were recorded. The changes of clinical symptoms, medical examinations and drug treatment by the age of 1 year were investigated by means of electronic medical record review and telephone follow-up.3) Results: A total of 286 infants were enrolled, 7 were lost to follow-up, and 279 were effectively followed up. There were 157 males and 129 females, with an age of 3.6 ± 1.5 months. The average stool frequency was 5.9 ± 1.8 days. 63.3% of the infants were breast-fed, 16.8% were formula-fed, and the rest were mixed-fed,all without supplementary food. 9.1% of the infants showed corresponding gastrointestinal symptoms, such as bloating, increased crying, decreased milk intake, and laborious defecation. 87.1% of the infants received medical treatment, including glycerin enema, probiotics, and Chinese herbal preparations, with an effective treatment rate of 7.8%. 38.7% of infants have undergone medical examination, including abdominal ultrasound, X-ray film / barium enema, blood test, etc, the positive rate is 14.8%. The duration of fecal retention in 53% of infants was ≤ 2 months, 22.6% between 2–3 months, 24.4% ≥ 3 months, with an average of 2.6 ± 1.1 months. At the age of followed up to 1 year, 16.8% of infants developed functional constipation(FC). Compared with other infants with normal defecation, there was no significant difference in age, frequency of stool, the proportion of breast milk feeding and receiving treatment, and there was a significant difference in the duration of fecal retention. The duration of FC group was longer than normal defecation group by which was 3.49 ± 0.83 months.4) Conclusions: Infants with fecal retention are more likely to develop FC at age 1 than general population, and may be positively related to the duration of fecal retention.