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Medical presentation of constipation from childhood to early adulthood: a population-based cohort study
Denesh K Chitkara1, Nicholas J Talley, G Richard Locke
1University of North Carolina Center for Functional GI and Motility Disorders, Division of Pediatric Gastroenterology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Insights
Early constipation diagnosis and being female increase the risk for future constipation issues in children and adults. This study tracked a birth cohort to understand these lifelong patterns.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Public Health
Background:
- Constipation is a prevalent condition affecting both children and adults.
- The influence of gender and early life factors on constipation development is not well understood.
Purpose of the Study:
- To determine the incidence of medical visits for constipation in a population-based birth cohort.
- To identify risk factors, including gender and early life events, associated with constipation from childhood to adulthood.
Main Methods:
- Utilized a birth cohort of children born between 1976-1982 in Rochester, Minnesota.
- Identified constipation cases through diagnosis codes and medical chart reviews.
- Followed subjects up to age 21, with 80% remaining in the community until age 18.
Main Results:
- Overall incidence of constipation presentation was 3.9 per 1000 person-years.
- Females showed a higher incidence of constipation starting at age 13 (RR 2.6-4.2).
- Children with constipation before age 5 had significantly higher rates of later medical visits (RR 2.5-4.5).
Conclusions:
- Early medical diagnosis of constipation is a key predictor of future visits.
- Female sex is associated with an increased incidence of constipation into early adulthood.
- These findings highlight the importance of early intervention and sex-specific considerations for constipation management.
Background & Aims:
Constipation is a common disorder in children and adults, but the role of gender and early life risk factors remains undefined. The aims of the study were as follows: (1) to estimate the incidence of medical presentation for constipation in a population-based birth cohort, and (2) to examine factors associated with constipation presentation from childhood to adulthood.
Methods:
A birth cohort of all children born between 1976 and 1982 to mothers who were residents of Rochester, Minnesota, and who remained in the community until age 5 was used for this study. Medical visits for constipation were identified by diagnoses codes and chart review. Subjects were followed up based on their diagnoses accumulated while younger than 21 years old, and 80% of subjects remained in the area until 18 years of age.
Results:
Of 5299 birth cohort members without constipation presentation before age 5, the overall age- and sex-adjusted incidence was 3.9 per 1000 person-years. A higher incidence for constipation in females occurred beginning at 13 years to early adulthood (rate ratio, 2.6 for 13-16 y and 4.2 for 17 to <21 y). Children with a diagnosis for constipation at younger than 5 years of age had a significantly higher incidence for subsequent medical visits for constipation through adolescence and early adulthood compared with the incidence rate of children without an early medical presentation (rate ratio, 4.5 for 5-8 y, 2.5 for 9-12 y, and 3.9 for 17-20 y).
Conclusions:
Early medical presentation and female sex influence incident and repeat medical visits for constipation from childhood to early adulthood.
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