Increased Prevalence of Obesity in Children With Functional Constipation Evaluated in an Academic Medical Center

Abstract

ABSTRACT. Objective. The rapidly increasing prevalence of obesity in children is the most important problem facing pediatricians today. A recent study suggested an association of obesity and constipation in children but lacked a control group for comparison. The objectives of this study were to evaluate the prevalence of obesity in a large cohort of children with functional constipation and to compare it with a control group representative of the general population.Methods. Retrospective chart review was performed on 719 children, between the ages of 4 and <18 years, with chronic functional constipation seen in the general pediatric and pediatric gastroenterology clinics between July 2002 and June 2004. Data collected included age, gender, BMI, and signs and symptoms of constipation including fecal incontinence. Obesity was classified as a BMI of >95th percentile and severe obesity as a BMI of >5 kg/m 2 above the 95th percentile for age and gender. The control group consisted of all 930 children (4 to <18 years of age) presenting to the pediatric clinic for a wellchild visit between January and June 2004. The 2 and t tests were used for analysis.Results. Overall prevalence of obesity was significantly higher in constipated children (22.4%) compared with control children (11.7%), and this higher prevalence was also seen for severe obesity. The prevalence rates of obesity were significantly higher in constipated males (25%) than in constipated females (19%) and were significantly higher compared with the control males (13.5%) and control females (9.8%). Constipated boys in all 3 age groups had significantly higher rates of obesity than the control boys; the constipated girls had significantly higher obesity rates for the age groups between 8 and <18 years. Fecal incontinence (encopresis) was present in 334 of 719 (46%) constipated children. The prevalence of obesity was similar in constipated children with and without fecal incontinence.Conclusions. There is a significantly higher prevalence of obesity in children with constipation compared with age-and gender-matched controls. This higher prevalence is present in both boys (4 to <18 years of age) and girls (8 to <18 years of age) with constipation and is not related to the presence of fecal incontinence among constipated children. T he rapidly increasing prevalence of obesity among children is one of the most challenging problems for pediatricians today. Obesity in children is associated with multiple health problems such as diabetes, hyperlipidemia, hypertension, steatohepatitis, and psychosocial issues. 1 However, there are minimal data on obesity and associated gastrointestinal symptoms in children. In adults, higher prevalence rates of chronic gastrointestinal symptoms have been reported in association with obesity. 2,3 In a recent pediatric study, a prevalence rate of 23% for constipation was reported in 80 obese children attending a tertiary obesity clinic. 4 Because this prevalence rate was higher than historical standards, the authors suggested an associa...

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