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Outcome of functional constipation in childhood: a 10-year follow-up study
Laurent Michaud1, Marie-Dominique Lamblin, Sophie Mairesse
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Faculty of Medicine and Children's Hospital, Lille University, France. l-michaud@chru-lille.fr
Insights
Nearly half of children with functional constipation experience persistent issues into adulthood. Anorectal dyssynergia is a key risk factor for long-term childhood constipation outcomes.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
Background:
- Functional constipation is a common pediatric condition.
- Long-term outcomes and risk factors for persistent constipation require further investigation.
Purpose of the Study:
- To evaluate the long-term outcomes of childhood functional constipation.
- To identify risk factors associated with persistent constipation into adolescence and adulthood.
Main Methods:
- A longitudinal study observed 72 children (mean age 4 years) with constipation.
- Initial assessments included colonic transit time and anorectal manometry.
- 45 patients were reevaluated 10-12 years later.
Main Results:
- 46% of patients remained constipated at long-term follow-up.
- Encopresis and recurrent abdominal pain were reported in 25% and 56% of patients, respectively.
- Anorectal dyssynergia was significantly associated with persistent constipation (61% vs. 29%, P < .05).
Conclusions:
- Childhood functional constipation has a high rate of persistence into adulthood.
- Anorectal dyssynergia is a significant predictor of poorer long-term outcomes in pediatric constipation.
Objectives:
To assess the outcome of patients presenting with functional constipation in childhood during a 10-year period and to determine any risk factors for developing persistent constipation throughout adolescence and adulthood.
Patients And Methods:
72 children (mean age 4 years; 40 boys) referred for constipation were included in a longitudinal set of observations. Initial workup included segmental colonic transit time and anorectal manometry; 45 of the 72 patients could be reevaluated 10 to 12 years later.
Results:
21 of 45 patients (46%; 95% confidence interval 29% to 67%) remained constipated at follow-up. Encopresis and recurrent abdominal pain were present in 25% and 56% of patients, respectively. Patients with anorectal dyssynergia remained more frequently constipated at follow-up than the others: 61% versus 29% (P < .05).
Conclusion:
Almost 50% of patients presenting with constipation during childhood remained constipated on long-term follow-up. Anorectal dyssynergia is associated with a worse prognosis.
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