Constipation in children: incidence, causes in relation to diet pattern and psychosocial aspects

Abstract

Background: The present study was conducted to study the incidence of constipation in children attending the paediatric Op and also to know the bowel pattern in constipated children and normal children with respect to food habits and regarding psychosocial aspect of toileting.Methods: A study was done at Katuri Medical College and Hospital in 654 children with age group of 2-12yr of either sex. Children who fulfilled the ROME III criteria for constipation were analysed for demographic profile, socio-economic status, psychosocial aspects and dietary habits affecting bowel pattern. Data was collected and recorded from the parents in pre-fixed proforma. Stool frequency and type of stool passed was recorded for a week, with Bristol stool chart. Children in the study group without constipation were analyzed in similar pattern.Results: A total of 654 children were analysed, out of which 202 children fulfilled the ROME III criteria for functional constipation. The prevalence of functional constipation was noted in 30.8% with female preponderance and incidence is more in the age group of2-4 years. In children without constipation, the average number of stools passed per day is 1.342 and the predominant type of stool is Type iv.Conclusions: Constipation continues to be a problem, mostly under recognised in older population. Psychosocial factors had a significant effect on functional constipation. Skipping breakfast, early toilet practising, low intake of vegetables and fruits were other factors leading to constipation.

Epidemiology, Demographic Profile and Clinical Variability of Functional Constipation: A Retrospective Study in North Bihar

“…Gannikan R et al 18 found increased incidence of functional constipation among male compared to females, similar result was found by khanna et al 4 Present study reveals that maximum number of functional constipation was between 2-5 yrs of age (Table 2). Similar results were obtained by Kokkonen et al 17 (mean age 2.5 yrs), Lorenzo et al 14 (between 2-4 yrs) and Kondepalli et al 5 (57.4% in 2-4 yrs of age). As far as socioeconomic status was concerned majority of children belong to lower socioeconomic group (56.19%) ( Table 2).…”

“…As far as clinical presentation was concerned the present study revealed that withholding behavior (42.85%) was present among constipated group. (Table3) Khanna et al 4 in the found withholding behavior in 27.4% while Kondapallics et al 5 noted higher incidence (58.4%). 21.58% of children presented with abdominal pain in our study (Table3) which is quite closer in comparison to study done by khanna et al 4 (18.8%), kokkonen et al 17 (26%), kondepallics et al 5 (30.6%).…”

“…Kokkonen et al 17 also found the increased incidence among girls. Kondepallics et al 5 found 54.4% incidence of functional constipation among females. Gannikan R et al 18 found increased incidence of functional constipation among male compared to females, similar result was found by khanna et al 4 Present study reveals that maximum number of functional constipation was between 2-5 yrs of age (Table 2).…”

“…(Table3) Khanna et al 4 found incidence of fecal impaction in the range of 40 -60% and fecal incontinence in 31% of children. Rectal bleeding was present in 10.89% of children with functional constipation by kondapalli cs et al 5 Children predominant on milk or related products diet have highest incidence (77.6%) of functional constipation. About 23.5% of children were consuming inadequate amount of green vegetables/roughage (Table 4).…”

“…Any delay or difficulty in defecation present for two or more weeks and sufficient to cause fecal incontinence, painful defecation, change in posture, withholding behavior is regarded as constipation. [1][2][3][4][5] This can be anatomical or functional. The prevalence of functional constipation in childhood varies from 0.7% to 29.6%.…”