Long-term follow-up of children with chronic idiopathic constipation

Staiano, Annamaria; Andreotti, Maria Rosaria; Greco, Luigi; Basile, Paola; Auricchio, Salvatore

doi:10.1007/bf02088343

Cited by 126 publications

(98 citation statements)

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“…É observado na literatura que o início da constipação intestinal é mais freqüente nesse grupo etário 1,5,[7][8][9][10][19][20][21][22] . A prática do desmame, com a introdução de mingaus concentrados e alimentos sólidos pobres em fibras e o baixo aporte hídrico, pode ser a responsável pelo surgimento do sintoma neste período.…”

Section: Discussionunclassified

“…A constipação intestinal é um dos distúrbios intestinais mais freqüentes e persistentes da infância [1][2][3][4][5] . Embora seja causa freqüente de consultas em ambulatórios pediátricos gerais e de gastrenterologia, o sintoma é pouco identificado, especialmente em sua fase inicial, pois a morbidade discreta não desperta atenção e/ou preocupação suficientes para que haja a queixa espontânea nas consultas pediátricas de rotina [6][7][8][9][10][11] .…”

Section: Introductionunclassified

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Chronic functional constipation in children:diagnosis and prevalence in a low-income community

Motta¹,

Silva²

1998

J Pediatr (Rio J)

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ResumoObjetivos: Determinar a prevalência de constipação intestinal crônica funcional em crianças menores de 11 anos residentes numa comunidade de baixa renda na cidade do Recife e validar o uso isolado das variáveis do hábito intestinal para diagnosticar constipação intestinal.Métodos: Foi realizado um estudo descritivo transversal. A partir de um censo, identificaram-se 536 crianças menores de 11 anos na Comunidade Campo do Banco. Os dados foram coletados através de formulário estruturado aplicado às mães. Considerou-se constipada a criança que apresentava no mínimo duas das seguintes queixas, há pelo menos trinta dias: eliminação dolorosa ou com esforço de fezes de consistência aumentada e/ou com freqüência inferior a três vezes por semana.Resultados: A prevalência de constipação intestinal crônica funcional foi de 17,5%. Na análise dos parâmetros isolados para diagnosticar constipação intestinal, esforço para defecar obteve maior sensibilidade (96,8%) e dor para defecar maior especificidade (99,5%).Conclusões: A constipação intestinal foi um sintoma prevalente nessa comunidade, alertando para a necessidade de busca ativa nas consultas pediátricas de rotina. Esforço para defecar foi identificado como o parâmetro isolado que permite o maior número de diagnósticos de constipação intestinal.J. pediatr. (Rio J.). 1998; 74(6): 451-454: constipação intestinal, prevalência, criança, diagnóstico. AbstractObjective: To investigate the prevalence of chronic functional constipation in children aged under 11 years of a low-income community in Recife, Northeast Brazil and to assess the validity of complaints of bowel habits for the diagnosis of constipation.Methods: A community-based survey identified 536 eligible children. Data collection was home-based through a structured questionnaire applied to the mothers. The definition of chronic functional constipation was based on painful defecation or with effort, with stools of hard consistency and/or frequency of defecation less than three times per week, during at least the last thirty days.Results: The prevalence of chronic functional constipation was 17.5%. Straining was the complaint which obtained the highest sensitivity for the diagnosis of constipation (96.8%) while pain to defecate obtained the highest specificity (99.5%).Conclusions: Chronic functional constipation was a prevalent symptom in this community, pointing out to the need of an active search in paediatric consultation. Straining was identified as the single complaint which better diagnosed constipation.J. pediatr. (Rio J.). 1998; 74(6): 451-454: constipation, prevalence, children, diagnosis. IntroduçãoA constipação intestinal é um dos distúrbios intestinais mais freqüentes e persistentes da infância [1][2][3][4][5] . Embora seja causa freqüente de consultas em ambulatórios pediátricos gerais e de gastrenterologia, o sintoma é pouco identificado, especialmente em sua fase inicial, pois a morbidade discreta não desperta atenção e/ou preocupação suficientes para que haja a queixa espontânea nas consultas pediá...

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Section: Discussionunclassified

Section: Introductionunclassified

Chronic functional constipation in children:diagnosis and prevalence in a low-income community

Motta¹,

Silva²

1998

J Pediatr (Rio J)

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“…Despite these treatment regimens, long-term follow-up studies have demonstrated that ϳ50% of these children continue to require therapy for long periods of time. 2 In the past 2 decades, manometric evaluation of anorectal function showed paradoxic contraction of the anal sphincter during defecation in 35% to 63% of constipated children. [3][4][5] This phenomenon may be caused by attempts to avoid defecation because of fears and pains experienced during defecation of hard stools early in life.…”

Section: Introductionmentioning

confidence: 99%

“…Despite these treatment regimens, long-term follow-up studies have demonstrated that ϳ50% of these children continue to require therapy for long periods of time. 2 From the …”

mentioning

confidence: 99%

The Effect of Anorectal Manometry on the Outcome of Treatment in Severe Childhood Constipation: A Randomized, Controlled Trial

Ginkel¹,

Büller

Boeckxstaens

et al. 2001

Pediatrics

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ABSTRACT.Objective. Approximately 50% of constipated children contract rather than relax the external sphincter complex during a defecation attempt. Although biofeedback training (BF) is able to change this defecation behavior, there is no additional effect of BF to conventional treatment (CT) on clinical outcome compared with CT alone. It has been postulated that the absence of a significant difference between these 2 treatment options might be because of a therapeutic, "demystifying" effect of performing anorectal manometry in conventionally treated children, necessary to obtain basal manometric data. The objective of this prospective, controlled, randomized study was to evaluate the effect of CT with 2 anorectal manometry sessions compared with CT alone (dietary advice, diary, toilet training, oral laxatives, and enemas) on clinical outcome.Methods. A total of 212 constipated children (143 boys) who were visiting a referral pediatric gastroenterologic practice were randomized prospectively to CT alone (115 patients) or to CT combined with 2 manometry sessions (CTM; 97 patients). Patients were included in the study when they fulfilled at least 2 of the 4 following criteria: stool frequency fewer than 3 per week, 2 or more soiling and/or encopresis episodes per week, periodic passage of very large amounts of stool every 7 to 30 days, or a palpable rectal or abdominal fecal mass. CT comprises dietary advice, a daily diary, toilet training, and oral laxative treatment preceded by rectal disimpaction with enemas on 3 consecutive days. During both manometries, the child and the parent could watch the tracing on the computer screen. No explanation was given to either the child or the parents during the procedure. When the procedure was finished, the tracings were clarified. Successful treatment was defined as a defecation frequency of 3 or more per week and fewer than 1 soiling/encopresis episode per 2 weeks and no use of laxatives.Results. Only 4 and 2 children from the CT and CTM groups showed no soiling and/or encopresis, whereas 76% and 65%, respectively, reported the periodic passage of large stools. In 26% and 30% of the patients, a rectal scybalum was found on physical examination. The success rates at 6, 26, 52, and 104 weeks' follow-up were 4%, 24%, 32%, and 43% and 7%, 22%, 30%, and 35% in the CT and CTM group, respectively. No significant difference in success percentage was observed between the 2 groups at any time of follow-up with relative risks (CT/CTM) and 95% confidence intervals, respectively, of 0.55 (0.16 -1.89), 1.13 (0.67-1.89), 1.07 (0.69 -1.65), and 1.23 (0.81-1.85). A significant increase in defecation frequency was observed between the first (intake) and second visits, which was sustained at all subsequent visits and stages of follow-up in both groups (not significant). Also in relation to the first visit, a significant decrease in encopresis episodes was shown and a further slow but significant decrease at 52 weeks of follow-up in both groups. The manometric data obtained from the CTM grou...

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“…Mothers of children seen for functional constipation at gastroenterology clinics often recall early onset of their child's symptoms (1,3,11,15,20,21,24,31,35) , and in Botucatu Medical School pediatric gastroenterology outpatient unit a long time gap was observed between the recalled onset of symptoms and first attendance, respectively at median 3 and 53 months of age (18) . But, data may be biased by the reliability of maternal recall after a long time lapse and by referral of the most severe cases.…”

Section: Introductionmentioning

confidence: 99%

Recalled and recorded bowel habits confirm early onset and high frequency of constipation in day-care nursery children

Borgo

Maffei

2009

Arq. Gastroenterol.

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-Context -Mothers recall early-onset constipation in children attending gastroenterology clinics. Objectives -To study the bowel habit of young children in the community to determine, first, whether early-onset constipation is confirmed in this setting and, second, the agreement between recalled and recorded bowel habit. Methods -Defecation data of 57 children aged 6.0-40.7 mo were obtained by maternal recall (questionnaire on predominant stool characteristics) and by record (1,934 defecations registered prospectively at home and in the nursery). The bowel habit was classified according to stool frequency and proportion of stool characteristics (soft, hard and/or runny). Two criteria were used to classify recorded data, since the cutoff point for hard stools to identify constipation is undefined in children: predominant criterion and adult criterion, respectively with >50% and ≥25% of stools with altered consistency. Bowel habit categories were: adequate, constipation, functional diarrhea and "other bowel habit". Nonparametric statistics, and the Kappa index for agreement between recalled and recorded bowel habit, were used. Results -Constipation occurred in 17.5%, 10.5%, 19.3% of the children by recall, the predominant and the adult criteria, respectively. Constipation was the main recalled alteration, vs 12.3% "other bowel habit". Only one child classified as having functional diarrhea (by the adult criterion). Agreement between recalled and recorded bowel habit was fair for constipation, by the predominant and the adult criteria (K = 0.28 and 0.24, respectively), but only slight (K ≤0.16) for other bowel habit categories. Individual data, however, pointed to a better relationship between recalled constipation and the adult rather than the predominant criterion. Conclusions -Frequent early-onset constipation was confirmed. Fair agreement between recalled and recorded constipation by the two used criteria indicates that recalled data are quite reliable to detect constipation.

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Long-term follow-up of children with chronic idiopathic constipation

Cited by 126 publications

References 13 publications

Chronic functional constipation in children:diagnosis and prevalence in a low-income community

Chronic functional constipation in children:diagnosis and prevalence in a low-income community

The Effect of Anorectal Manometry on the Outcome of Treatment in Severe Childhood Constipation: A Randomized, Controlled Trial

Recalled and recorded bowel habits confirm early onset and high frequency of constipation in day-care nursery children

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