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Bladder Symptoms in Children With Functional Constipation: A Systematic Review
Jojanneke J G T van Summeren1, Gea A Holtman, Sonja C van Ommeren
1Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Insights
Bladder symptoms are common in children with functional constipation (FC), affecting up to 47%. Children with FC are significantly more likely to experience these symptoms, highlighting the need for clinical awareness.
Area of Science:
- Pediatric Gastroenterology
- Urology
- Public Health
Background:
- Functional constipation (FC) is a common pediatric condition.
- Bladder symptoms frequently coexist with FC, impacting children's quality of life.
- Understanding the prevalence of bladder symptoms in FC is crucial for effective management.
Purpose of the Study:
- To systematically review the literature on the prevalence of bladder symptoms in children with FC.
- To compare the prevalence of bladder symptoms in children with FC versus those without FC.
Main Methods:
- A systematic review of four databases was conducted up to July 2018.
- Studies included children aged 4-17 years with FC; data on bladder symptoms and urinary tract infections (UTIs) were extracted.
- Prevalence rates and relative risks were calculated; study quality and heterogeneity were assessed.
Main Results:
- Twenty-two of 23 studies reported bladder symptoms in 12,281 children with FC.
- Prevalence rates for bladder symptoms ranged from 2% to 47%, lower urinary tract symptoms (LUTS) from 37% to 64%, and UTIs from 6% to 53%.
- Children with FC showed significantly higher risks for bladder symptoms (RR 1.24-6.73) and UTIs (RR 2.18-6.55).
Conclusions:
- Bladder symptoms are prevalent in children with functional constipation, though reported rates vary widely.
- Children experiencing FC are at a higher risk of developing bladder symptoms.
- Clinicians should consider and assess for co-occurring bladder symptoms in pediatric patients with FC.
Objective:
The aim of the review is to perform a systematic review of the literature examining the prevalence of bladder symptoms in children with functional constipation (FC) and to compare the prevalence of those symptoms between children with and without FC.
Methods:
In this systematic review 4 databases were searched to July 2018. Studies investigating the prevalence of bladder symptoms in children aged 4 to 17 years with FC were included. There was no language restriction. Two reviewers independently extracted data and assessed study quality. Clinical heterogeneity between studies was investigated. Prevalence rates of bladder symptoms in children with FC were calculated. Relative risks were calculated to compare the prevalence of bladder symptoms between children with and without FC.
Results:
Among 23 studies of children with FC, 22 reported the prevalence bladder symptoms (12,281 children) and 7 reported the prevalence of urinary tract infections (UTIs) (687 children). The prevalence rates of single bladder symptoms, lower urinary tract symptoms (LUTS), and UTI varied between 2% to 47%, 37% to 64%, and 6% to 53%. The relative risks were 1.24 to 6.73 for 20 single bladder symptoms (12 studies) and 2.18 to 6.55 for UTI (2 studies). The 95% confidence intervals indicated significance in 14 of 20 single bladder symptoms.
Conclusions:
Bladder symptoms seem common in children with FC, but the reported prevalence varies greatly. Children with FC are more likely to have bladder symptoms than children without FC. We recommend that clinicians be aware of concomitant bladder symptoms in children presenting with FC.
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