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The association of constipation with childhood urinary tract infections
Karla M Giramonti1, Barry A Kogan, Olayemi O Agboola
1The Urological Institute of Northeastern New York and Department of Surgery, Albany Medical College, 23 Hackett Boulevard, Albany, NY 12208, USA. kgiramonti@communitycare.com
Insights
Children with a history of urinary tract infections (UTIs) are more likely to experience constipation. However, diagnosing constipation is challenging due to poor correlation between symptoms and radiographic findings.
Area of Science:
- Pediatric Nephrology
- Pediatric Gastroenterology
Background:
- Previous studies suggest a link between constipation and urinary tract infections (UTIs) in children.
- Historical data on constipation can be unreliable, and its relationship with radiographic fecal load is unclear.
Purpose of the Study:
- To investigate the correlation between constipation history and radiographic fecal load in children with and without UTIs.
- To assess the diagnostic challenges in identifying constipation in pediatric patients.
Main Methods:
- 133 children undergoing abdominal X-rays were evaluated.
- Parental questionnaires on bowel habits were administered.
- Radiographic findings of fecal load were assessed using an objective scoring system.
Main Results:
- Children with prior UTIs showed significantly more constipation symptoms (p<0.02).
- A trend towards increased fecal loading in children with UTIs was observed, but not statistically significant (p<0.11).
- A poor correlation (r=0.08) was found between reported constipation symptoms and radiographic fecal load.
Conclusions:
- Children with UTIs exhibit a higher incidence of constipation, particularly based on historical reports.
- Diagnosing constipation in individual children is difficult due to the poor correlation between subjective history and objective radiographic findings.
- Currently, there is no established gold standard for diagnosing constipation in children.
Objective:
Previous studies have suggested a correlation between constipation and urinary tract infections (UTIs) in children. However, historical information about constipation may be unreliable and the relationship between a history of constipation and radiographic findings of fecal load is unclear.
Patients And Methods:
A total of 133 children undergoing an abdominal X-ray were evaluated. Parents were asked to complete a questionnaire on bowel habits. Three observers using a documented objective scoring system evaluated plain films of the abdomen. The symptom and radiographic scores were compared with the history and each other.
Results:
Out of the 133 children, 100 had documented previous UTIs and 33 did not. Children with prior UTIs had significantly more symptoms of constipation than those without prior UTIs (p<0.02). Children with a history of UTIs tended to have more fecal loading on radiographic studies than those without, although this difference was not statistically significant (p<0.11). When only children of >3 years old are evaluated, the trends persist, but neither were statistically significant (p<0.11 and 0.56, respectively). There was a poor correlation between the symptoms of constipation and fecal load on abdominal X-rays (correlation coefficient of 0.08).
Conclusions:
Our findings support the concept that children with UTIs have a higher rate of constipation, especially by history. However, diagnosing constipation in individual patients is difficult. Not only is there a poor correlation between history and radiographic findings of constipation in any individual patient, but at this time there is no gold standard.
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