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

Abstract

Introducton: Constipation is a worldwide problem. Current research aimed to study the various determinants of functional constipation and clinical spectrum in north Bihar. Thus creating tangible evidence for the policy makers. Material and methods: Retrospective hospital record based cross sectional study was conducted at tertiary care Darbhanga medical college and hospital (DMCH). Children between 2-12 years with chief presenting complaint of constipation in pediatric OPD and IPD during July 2013 to June 2014 were identified. Only those who fulfilled the ROME 3 criteria of functional constipation were included in the study. Children with any organic cause of functional constipation and children getting treatment for functional constipation were excluded from the study. Results: Total 892 children were examined during the study period, of which 343 children were diagnosed to have constipation. Among them 315 (35.31%) children were qualified to have functional constipation as per ROME 3 criteria. 28 cases (3.14%) have organic cause of which 15(53.57%) had Hirschprung's disease Mean age of toilet training was 17.2 months. Females were more affected (61.58%) than males. Maximum cases were between 2-5 yrs (62.2%), lower socioeconomic status (56.19%)and rural background (50.15%).lack of indoor toilets and dirty school toilets precipitates constipation particularly in girls. Conclusion: constipation causes physical, psychological morbidity and poor quality of life, hence early diagnosis and management is of utmost importance. Lack of indoor clean toilets, early toilet training, unhygienic school toilets, improper roughage intake should be taken care of by parents/ authority.

Understanding Childhood Constipation Through the Prism of the Caretaker

“…It is well established that habitual constipation is successfully managed with dietary and lifestyle modification. [ 1 8 14 ] In the present study, however, there were some who felt the need to use medication prescribed by a physician or those available over the counter at the outset of the symptoms. Although these are effective treatment strategies, sensitizing caregivers to a preventive rather than curative intent is the need of the hour.…”

“…What was reassuring was that most mothers irrespective of their background recognized that their child being constipated would adversely affect family and school life. In keeping with this finding, there is sufficient literature[ 1 8 13 ] to suggest that childhood constipation is detrimental to physical, mental, and social health. Discussion on constipation is considered taboo by some,[ 3 ] yet, in our study, only a minor group claimed to feel embarrassed or awkward to talk about it.…”

“…Childhood constipation accounts for about 3% of all outpatient visits to the pediatrician and a third of all pediatric gastroenterology consultations. [ 1 ] The global prevalence is 0.7%–29.6%,[ 1 2 ] with functional constipation as the leading cause. The cohort of constipated children seeking outpatient care at pediatric surgical clinics is increasing.…”

Outcome of Functional Constipation in Children Age 1 to 12 Year in Tertiary Care Hospital

“…Toilet facilities are essential for providing hygienic treatment for all age groups; in indoor facilities, the number of patients experiencing constipation was 133(34.90%) lower than in outside facilities. 248(65.09) had a higher ratio of constipation, and investigations with a comparable finding were made of students [13][14][15][16] .There were 13(3.41%) fewer cases of uncomfortable stools with ROME criterion IV presentations than in studies [17][18] . Children not using the school lavatory accounted for 181(47.5%) of the factors linked with constipation, while oppositional behavior 73(19.16%) and temper tantrums 35(9.18%) were less common.…”

Clinical Profile of Constipation in Children Under 5 Years of Age in Dr. Soetomo General Academic Hospital, Indonesia

“…12 Constipation significantly affects children behaviour, from withholding behaviour, stiffening body, to hiding in a corner or fidgeting with the urge to defecate. 13 Childhood constipation has great impact on children's nutritional status or growth status, quality of life, and may lead to various complication if left with inadequate treatment. 14,15 However, clinical profile of childhood constipation in developing countries, particularly Indonesia, has not been recorded completely.…”