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Defecation patterns in infants: a prospective cohort study.

Esther A H Kramer1, Jolanda H den Hertog-Kuijl1, Leonard M C L van den Broek2

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Infant dyschezia prevalence is lower than previously thought, with symptoms decreasing by age. Current definitions may be too strict, and symptoms do not predict functional constipation.

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Area of Science:

  • Pediatrics
  • Gastroenterology
  • Child Health

Background:

  • Infant dyschezia, characterized by prolonged straining before passing soft stools, lacks sufficient prevalence and natural history data.
  • The Rome III criteria define infant dyschezia, but its clinical application and parental perception require further investigation.

Purpose of the Study:

  • To determine the prevalence and natural history of infant dyschezia using Rome III criteria.
  • To compare Rome III criteria with parental reporting of dyschezia-like symptoms.
  • To assess the relationship between infant dyschezia and the development of functional constipation.

Main Methods:

  • A national study involving 124 youth healthcare doctors.
  • Standardized questionnaires and bowel diaries collected data from 1292 infants at 1, 3, and 9 months of age.
  • Infants were assessed based on Rome III criteria and modified criteria reflecting parental concerns.

Main Results:

  • At 1 and 3 months, 3.9% and 0.9% of infants met Rome III criteria for infant dyschezia, respectively.
  • Parental reports of dyschezia-like symptoms (modified criteria) were higher: 17.3% at 1 month and 6.5% at 3 months.
  • Infant dyschezia prevalence decreased with age, and few cases progressed to functional constipation.

Conclusions:

  • The current Rome III definition for infant dyschezia may be too restrictive.
  • A broader definition encompassing parental-reported symptoms and a wider age range is suggested.
  • Infant dyschezia prevalence declines with age and shows no significant association with the development of functional constipation.