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How do we define normal bowel frequency from newborn to teens?: A Bayesian meta-analysis.

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Summary
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This study analyzed bowel frequencies in healthy children aged 0-18 years. Younger children, like newborns, have more frequent bowel movements than older children.

Keywords:
Bayesian analysisbowel habitschildrenconstipationmeta‐regression

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Area of Science:

  • Pediatric Gastroenterology
  • Developmental Biology

Background:

  • Defecation disorders are common in children.
  • Bowel frequency is a key indicator for diagnosing these disorders.

Purpose of the Study:

  • To establish normal bowel movement frequencies for healthy children from birth to adolescence.
  • To provide reference values for clinical use in identifying pediatric defecation disorders.

Main Methods:

  • A comprehensive literature search was performed across major databases (MEDLINE, SCOPUS, EMBASE, Cochrane, Web of Science) up to February 2024.
  • Bayesian distribution modeling with inverse-variance weighing was used to pool data from 17 studies involving 22,698 children.
  • Subgroup analyses and meta-regression were conducted, with study quality assessed using a modified Newcastle-Ottawa Scale.

Main Results:

  • Mean bowel frequencies were determined for various age groups: newborns (3.24), 1-6 months (1.99), 6-12 months (1.66), 1-2 years (1.53), 2-5 years (1.15), and over 5 years (1.02).
  • The variance in bowel frequency distribution decreased with increasing age.
  • Heterogeneity between studies was near-normally distributed.

Conclusions:

  • This Bayesian meta-analysis confirms that bowel movement frequency decreases with age in children.
  • The established age-specific normal bowel frequencies can aid clinicians in differentiating healthy bowel habits from pediatric defecation disorders.