Epidemiology of childhood constipation: a national study of Swedish children from 2006 to 2023

Childhood constipation is increasingly common, yet its prevalence is uncertain. This study examines comprehensive national data for trends in medically treated childhood constipation over a period of 18 years.

Included were all Swedish children, 0-14 years, 2006-2023, and all prescriptions for constipation, using the national Swedish Prescribed Drug register. The primary outcome was the number of unique patients prescribed, presented by age, gender, year, county, and ATC-code. Univariate and multivariable linear regression with ecological data were assessed for associations with age, gender, and year of prescription.

The study population increased from 1.54 to 1.84 million children 0-14 years, while constipation increased more than sixfold, from 1.2% in 2006 to 7.9% in 2023. Children 0-4 years were prescribed the most, with an increase from 1.6 to 9.5%. Female gender was associated with 7.5 higher prescription frequency per 1000 inhabitants when adjusted for age and year (4.6-10.5 95%CI, p < 0.001). In 2023, girls aged 0-4 years were prescribed 27% more than boys (106.5 vs. 83.7 per 1000), compared with 23% among the 5-9-year-olds (86.8 vs. 70.6 per 1000), and 18% among the 10-14-year-olds (45.0 vs. 38.1 per 1000).

Prescription of constipation drugs to children has increased remarkably during the past 18 years. This study highlights an escalating public health challenge among children, with considerable associated costs for family and society.