Constipation in very-low-birth-weight children at 10 to 14 years of age

C Cunningham1, H G Taylor, N M Minich

  • 1Department of Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, U.S.A. cxc55@po.cwru.edu

Insights

Very-low-birth-weight children (<750g) with constipation show higher rates of neurodevelopmental issues and toileting problems. Early intervention for constipation may reduce these complications in this vulnerable population.

Area of Science:

  • Pediatrics
  • Neurodevelopmental Disorders
  • Gastroenterology

Background:

  • Very-low-birth-weight (VLBW) infants (<750g) exhibit elevated rates of neurosensory and cognitive impairments.
  • Constipation is unexpectedly prevalent in VLBW children, affecting 32% of those studied.
  • The high incidence of constipation warrants further investigation into its association with neurodevelopmental outcomes in VLBW children.

Purpose of the Study:

  • To evaluate the prevalence and impact of constipation and associated toileting issues in VLBW children.
  • To determine the relationship between constipation and neurodevelopmental impairments in VLBW children.

Main Methods:

  • A case-control study matched 19 VLBW children with constipation to VLBW controls without constipation based on age, sex, and race.
  • A telephone questionnaire was administered to parents of 15 constipated VLBW children and their matched controls.

Main Results:

  • Constipated VLBW children had significantly higher rates of neurosensory impairment (47% vs. 7%) and lower mean IQ scores (72 vs. 89).
  • Associated toileting problems, including encopresis (53% vs. 7%) and stool withholding (60% vs. 13%), were significantly more common in the constipated group.

Conclusions:

  • Constipation in VLBW children is linked to neurodevelopmental impairments.
  • Increased awareness and proactive interventions to promote regular bowel movements are crucial for mitigating constipation and related toileting problems in this population.
Abstract

Related Concept Videos

Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives01:22

Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives

Laxatives enhance bowel movements and alleviate constipation. They augment the stool's bulk, stimulate intestinal muscle contractions, draw water into the intestines, or soften the stool. There are five key types of laxatives: bulk laxatives, stimulant laxatives, osmotic laxatives, stool softeners, and lubricant laxatives.
Bulk-forming laxatives, such as psyllium, methylcellulose, and polycarbophil, absorb water in the intestine, increasing stool bulk and promoting bowel movement. This makes...
Drugs Affecting GI Tract Motility: Other Laxatives01:20

Drugs Affecting GI Tract Motility: Other Laxatives

Laxatives are primarily used to alleviate constipation, a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty passing stools. They work by various mechanisms to increase the volume or frequency of bowel movements. The primary modes of action of laxatives include increasing stool bulk, softening the stool, stimulating intestinal motility, and osmotically drawing water into the intestines.
Osmotic or saline laxatives, like magnesium hydroxide or milk of...