Prevalence, Clinical Characteristics, and Management of Functional Constipation at Pediatric Gastroenterology Clinics

Abstract

The purpose of this study was to investigate the prevalence, clinical characteristics, and management of functional constipation at pediatric gastroenterology clinics. A prospective survey using the Rome III criteria was distributed to a group of parents of children with a constipation history and its control group in May 2008. The mean prevalence of constipation was 6.4%, which was similar to those in other countries. Statistically significant variables for children without constipation were that more children had a body mass index of below the 10th percentile even though they received more mother's care and ate balanced meals compared to the constipation group. Meanwhile, the constipation group frequently showed a history of constipation in infancy, picky-eating, lack of exercise, and retentive posturing. When analyzed with the Rome III criteria, the children showed greater than 60% rate of hard stools, painful stools, a history of large fecal mass in rectum, and its disappearance of constipation symptoms after passing a large stool. Our study found different approaches amongst pediatric gastroenterologists like rectal examinations, disimpaction, or drug treatment. Several factors addressed in our study can provide better guidelines for clinicians treating constipation and its future research.

Investigation of Demographic and Clinical Characteristics of Children with Constipation Referring to the Pediatric Gastrointestinal Clinic, Shiraz in 2014 - 2016

“…The mean age of the constipated children in our study was 4.8 years, which was comparable with the results of other studies (10,11). However, the children's mean age was higher in the studies performed by Inan et al (12) and Faleiros et al (13).…”

Prevalence and Factors Associated With Functional Constipation Among Children Attending Well Baby Clinic in Aladel Primary Health Care Center in Makkah Al-Mukarramah, 2016, Cross Sectional.

“…The same has been reported in another study carried out in Korea (14) . On the other hand, Minkyu Park et al reported that 500 ml or less of daily water intake was significantly associated with functional constipation (15) .…”

“…In Northern areas of China, among children aged 4 -14 year, the prevalence of functional constipation was 4.7% with high prevalence in the age group 4 -6 years (12) . In USA, among children up to three years of age, 27.1% had at least one functional gastrointestinal disorder (13) .In Korea, among children ages at least 12 months the prevalence range was from 1.8% to 13.9% (14). The variation between prevalence rates of functional constipation among children in the aforementioned studies including ours could be mainly attributed to apparent difference in the age group of the studied population.…”

“…In Colombia, the mean age of children was 19.3±15.3 months (11) . In Korea, the mean age was 54.5±15.1 months (15) .In another study that was carried out in Korea, the mean age was 60.5±41.8 months (14) while in Iran the mean age was 5±3.12 years (17) . It has been documented that in general population, nearly 75% of those who experienced functional constipation were between the ages 5-10 years.…”

“…In a study carried out by Dehghani et al (2015) (17) , hard and large stool, painful defecation and retentive posture were observed among majority of cases (93.7%, 92.3% and 91.9%, respectively), soiling was reported by 33.8% of the cases, fecal mass and fecal impaction was present in 9.5%, 59.9% of them, respectively. Chang et al, reported that 68% of their cases had a history of large fecal mass in the lower abdomen and 60% of them had hard stool consistency and painful defecation, while about one-third of the cases had a history of retentive posture, weekly soiling and stool frequency 2 times or less per week (14) . In another study carried out in Korea, painful defecation and hard stool was reported in 55.6% of cases, retentive posture was reported by 50% of the cases while 44.4% of them reported a stool frequency 2 times or less per week and a history of large fecal mass in the rectum, 38.9% had a history of large stool that obstruct the toilet and 27.8% reported soiling once per week or more (15) .…”