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Occult constipation in children: An unaddressed problem of our day-to-day practice
M D Benzamin1, Md Ziaur Rahman Chowdhury2, Pranto Chakroborty3
1Department of Paediatric Gastroenterology and Nutrition, Sylhet MAG Osmani Medical College Hospital, Sylhet 3100, Bangladesh. drmd.benzamin@yahoo.com.
Insights
Occult constipation (OC) is a common, yet overlooked, issue in children. Abdominal pain is its most frequent symptom, highlighting the need for considering OC when other causes are ruled out.
Area of Science:
- Pediatric Gastroenterology
- Clinical Research
- Digestive Health
Background:
- Constipation is a prevalent pediatric issue, frequently leading to outpatient and emergency visits.
- Occult constipation (OC) is an underdiagnosed condition within the pediatric population.
- Understanding the clinical presentation of OC is crucial for timely diagnosis and management.
Purpose of the Study:
- To investigate the clinical profile of occult constipation (OC) in children.
- To identify common symptoms associated with OC in pediatric patients.
- To raise awareness of OC as a differential diagnosis in children with unexplained gastrointestinal symptoms.
Main Methods:
- Prospective observational study conducted in Bangladesh (January 2022 - December 2024).
- Included consecutive children diagnosed with OC after excluding secondary causes.
- Follow-up for 4 months to assess treatment response based on symptom improvement.
Main Results:
- 404 children were included, with a mean age of 76.50 ± 36.62 months and a male-to-female ratio of 1.67:1.
- The most common presenting complaint was abdominal pain (66%).
- Other frequent symptoms included anorexia (49%), vomiting (24%), and failure to thrive (14%); 2.5% presented with persistent diarrhea.
Conclusions:
- Abdominal pain is the most common presenting symptom of occult constipation in children.
- OC should be considered in the differential diagnosis for children with unexplained symptoms, especially gastrointestinal issues.
- Early recognition and management of OC can improve pediatric patient outcomes.
Background:
In our day-to-day practice, constipation is a common problem in the pediatric population and cause of frequent visit in outpatient and emergency department. But occult constipation (OC) remains as the most unaddressed problem.
Aim:
To investigate the clinical profile of OC in children.
Methods:
It was a prospective observational study, done in Bangladesh from January 2022 to December 2024. It included all consecutive children diagnosed as OC and were treated accordingly. Before diagnosis, secondary causes of the presenting symptoms were excluded with appropriate investigations. They were followed up monthly for 4 months and treatment response were measured by improvement of symptoms.
Results:
A total of 404 children were included in this study with mean age group of 76.50 ± 36.62 months, and male-female ratio of 1.67:1. The most common presenting complaint was abdominal pain (66%), followed by anorexia (49%), vomiting (24%), nausea (17%), frequent defecation with small volume stool (17%), altered bowel habit (16%), failure to thrive (14%) and recurrent helminthiasis (12%). Interestingly, 2.5% children presented with persistent diarrhea.
Conclusion:
Abdominal pain is the most common presentation of OC. When symptoms cannot be explained by other etiology, OC should be kept in mind.
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