Evaluation of Constipation in Pediatric Patients with Osteogenesis Imperfecta
Katie Vanderzwaag1, Jay Byrd1, Matthew Van Ormer1,2
1University of Nebraska Medical Center, Omaha, NE, USA.
Insights
Constipation is common in Osteogenesis Imperfecta (OI), a genetic bone disorder. This study found a significant link between OI severity, weakness, acetabular protrusion, and constipation in children with OI.
Area of Science:
- Pediatric Orthopedics
- Genetics
- Gastroenterology
Background:
- Osteogenesis Imperfecta (OI) is a genetic connective tissue disorder characterized by brittle bones and frequent fractures.
- Constipation is a prevalent and often multifactorial symptom in children with OI.
- The relationship between OI type, complications, and constipation has not been previously assessed in this patient population.
Purpose of the Study:
- To investigate the association between Osteogenesis Imperfecta (OI) type, OI-related complications, and the occurrence of constipation in pediatric patients.
- To identify potential contributing factors to constipation in children diagnosed with OI.
Main Methods:
- A retrospective review of medical charts and radiographic data was performed on 98 children with OI.
- Data collected included OI type, age, gender, gastrointestinal symptoms, mobility scores, overall functionality, acetabular protrusion, and fecal loading.
- Statistical analysis was used to determine significant associations between variables.
Main Results:
- Constipation was reported in a significant proportion of children with OI, with higher prevalence in more severe OI types (e.g., Type III).
- A statistically significant association was found between OI severity and constipation (P < .001).
- Weakness (55.6% vs. 21.1%, P = .001) and acetabular protrusion (60% vs. 27.4%, P < .01) were significantly associated with increased constipation rates.
Conclusions:
- The study suggests a strong link between the severity of Osteogenesis Imperfecta and constipation.
- Patient weakness and acetabular protrusion are identified as significant contributing factors to constipation in OI.
- Further research into the causes and optimal treatments for constipation in OI patients is warranted.
Abstract:
Background. Osteogenesis imperfecta (OI) is a genetic disorder of connective tissue that often presents with fractures and bone bowing. Constipation is a common symptom in OI and is likley multifactorial. To our knowledge no assessment of the relationship between OI type, OI complications, and constipation has been conducted in this vulnerable patient population. Methods. A retrospective chart and radiographic review was conducted to assess the relationship between constipation and OI type, age, gender, GI symptoms, mobility scores and overall functionality. A total of 98 children with OI were included. Radiographs were analyzed to determine the presence of acetabular protrusio and the degree of fecal loading. Results. Fifty-three female (54%) and 45 male (46%) OI children with a median age of 85.8 months were analyzed. OI types were 30.6% Type I, 30.6% Type III, 27.6% Type IV, and 11.2% other. Constipation was reported in 60%, 26.7%, 11.1%, and 54.5% of children with types III, I, IV, and other, respectively. There was a statistically significant association between the severity of OI and the report of constipation (P < .001). Participants who reported weakness had a higher percentage of constipation, 55.6% versus 21.1%, (P = .001). Sixty percent of children with acetabular protrusion reported constipation, while only 27.4% of children without acetabular protrusion reported constipation (P < .01). Conclusion. Our study demonstrates a potential link between constipation and severity of OI, with weakness as a likely contributing factor. This study also affirmed an association between acetabular protrusion and constipation. Constipation warrants further investigation in OI as to cause and treatment.
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