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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

  • 1Jeugdgezondheidszorg, Stichting Thuiszorg Midden-Gelderland, Bemmel, The Netherlands.

Archives of Disease in Childhood
|December 26, 2014
PubMed

Insights

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.

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.
Abstract

Keywords:
Comm Child HealthGastroenterologyGeneral Paediatrics

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