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Outcome in children under 5 years of age with constipation: a prospective follow-up study
N Elshimy1, B Gallagher, D West
1Children's Centre, General Infirmary at Leeds, UK.
Insights
Most preschool children with constipation improve with simple treatments and support. A small number may need more intensive psychological management for long-term defecation issues.
Area of Science:
- Pediatrics
- Gastroenterology
Background:
- Constipation is common in preschool children, causing distress and potential long-term defecation difficulties.
- Limited information exists on the prognosis for this age group.
- Previous research identified characteristics of hospitalized idiopathic constipation cases in children under 5.
Purpose of the Study:
- To report 18-month outcome data for preschool children with idiopathic constipation.
- To summarize best practices for managing constipation in this age group.
Main Methods:
- Follow-up data collected after 18 months on 41 of 42 children from a previous cohort.
- Assessment of symptom resolution and ongoing treatment needs.
Main Results:
- Constipation symptoms resolved in 36 (88%) children after 18 months.
- Seven children (20% of resolved cases) still required regular laxative treatment.
- Five children showed no improvement, potentially linked to psychosocial issues and poor treatment compliance.
Conclusions:
- Preschool children with constipation generally have an optimistic prognosis with simple treatments and ongoing support.
- A minority of non-improving cases may benefit from intensive psychological management.
- Effective management involves addressing psychosocial factors and ensuring treatment compliance.
Abstract:
Constipation in the pre-school child is common and causes considerable distress to children and their parents. There is a lack of information regarding prognosis in this group of patients although some are clearly at risk of developing long-term difficulties with defaecation. We have previously reported characteristics of children under 5 years of age referred to hospital over a one-year period with idiopathic constipation. We now report outcome data after 18 months of follow-up in 41 of the original cohort of 42 children. We have also summarised what we regard as good practice in managing constipation in this age group. Eighteen months after initial outpatient assessment, the symptoms of constipation were reported to have resolved in 36 (88%), although seven of these were still needing regular laxative treatment. It was our subjective impression that the five children who apparently did not improve came from families that had a greater degree of psychosocial problems and where compliance with treatment was suspect. This study shows that with simple treatment measures and ongoing support, an optimistic prognosis can be given to families from the outset. The minority of pre-school children who do not improve may benefit from a more intensive psychological approach to management.