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A 6-year follow-up study of chronic constipation and soiling in a specialist paediatric service
1Canada House, Barnsole Road, Gillingham, Kent, ME7 4JL, UK. EProcter@invicta-tr.sthames.nhs.uk
Insights
Many children with chronic constipation and soiling continue to experience symptoms years later. Distress was high for both children and parents, highlighting the need for further research into effective treatments.
Area of Science:
- Pediatric Gastroenterology
- Childhood Functional Gastrointestinal Disorders
Background:
- Chronic constipation and soiling are common in childhood, often with a prolonged course.
- Long-term outcomes for children with these conditions are not well-established.
Purpose of the Study:
- To investigate the long-term outcomes of children with chronic constipation and soiling.
- To follow up a cohort of children 6 years after their initial presentation to a specialist clinic.
Main Methods:
- Retrospective postal survey of children referred to a specialist pediatric gastroenterology clinic in 1991.
- Semi-structured questionnaires sent to families; Strengths and Difficulties Questionnaire (SDQ) administered to a random sample.
Main Results:
- A high response rate (89%) was achieved.
- Over a third (36%) of children still experienced constipation and soiling 6 years later; 17% used regular laxatives.
- Significant distress was reported by both children and parents, regardless of symptom improvement.
Conclusions:
- A substantial proportion of children referred to specialist care continue to have chronic constipation and soiling issues long-term.
- Further research is needed to identify predictive factors for persistent problems and effective interventions.
Objective:
Constipation and soiling is a relatively common condition in childhood and its course is often chronic. This study investigated long-term outcome of children with chronic constipation and soiling by following up a cohort of children 6 years after their presentation to a specialist paediatric gastroenterology clinic with chronic constipation and soiling.
Design:
Retrospective postal survey.
Setting/Sample:
All children referred in 1991 to a specialist paediatric gastroenterology clinic accepting both secondary and tertiary referrals.
Measures:
A semi-structured postal questionnaire was sent to all families, and the Strengths and Difficulties Questionnaire (SDQ) was sent to a random sample.
Results:
The response rate (of those who could be traced) was 89%. Of these, over a third (36%) still had a problem with constipation and soiling and 17% were using regular laxatives. Three people still having problems with constipation and soiling in the sample were aged over 18 years. No significant difference was found with regard to age, sex or age at referral between the group that improved and the group that did not. Both groups felt they had suffered a high degree of distress because of the problem, with parents highlighting their powerlessness to help their child and the child identifying the embarrassment caused by the problem.
Conclusions:
A significant number of children presenting to a specialist paediatric clinic continue to have problems for several years. Further research is needed to identify these cases and to identify which factors promote resolution of the problem.