Blood lead level evaluation in children presenting with chronic constipation in Tehran-Iran: a cross-sectional study

Area of Science:

• Pediatric Gastroenterology
• Environmental Health
• Toxicology

Background:

• Constipation is a prevalent pediatric health concern globally.
• Abdominal complaints and constipation are frequently observed in children with lead poisoning.
• Elevated blood lead levels (BLL) pose significant health risks to children.

Purpose of the Study:

• To determine the prevalence of abnormal blood lead levels (BLL) in pediatric and adolescent patients presenting with constipation.
• To investigate the association between constipation and elevated BLL in this population.
• To identify factors associated with elevated BLL in children with constipation.

Main Methods:

• Prospective data collection from 237 pediatric patients (<18 years) with constipation (ROME IV criteria).
• Blood lead levels (BLL) measured using the LeadCare II device (electrochemical technique).
• Multivariate analysis to identify associations with elevated BLL, including symptoms and maternal education.

Main Results:

• 20.67% of enrolled patients had BLL ≥ 5 µg/dL, with a mean BLL of 3.51 µg/dL.
• Abdominal pain was the most common accompanying symptom (56%).
• Endoscopic evaluation, muscle pain, and maternal education were significantly associated with elevated BLL.

Conclusions:

• Elevated BLL is prevalent in children with constipation, necessitating lead exposure reduction strategies.
• BLL screening in children with refractory chronic constipation and abdominal pain may prevent unnecessary invasive procedures.
• Early identification and management of lead exposure are crucial for pediatric health.