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Sociodemographic and Clinical Characteristics of Functional Constipation in Children Receiving Care at a Tertiary
Nirjala Aryal1, Moon Thapa1, Bishwo Raj Bahadur Kunwar1
1Department of Paediatric Medicine, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal.
Insights
Functional constipation affects 14.4% of children globally. This study details its characteristics in Nepalese children, highlighting symptoms like hard stools and abdominal pain to guide early diagnosis and intervention.
Area of Science:
- Pediatric Gastroenterology
- Clinical Research
- Global Health
Background:
- Functional constipation (FC) is a common pediatric issue with a global prevalence of 14.4% (Rome IV criteria).
- FC often stems from voluntary stool withholding, leading to painful defecation and other symptoms.
- Data on FC in developing nations, such as Nepal, is limited.
Purpose of the Study:
- To investigate the sociodemographic and clinical characteristics of functional constipation in Nepalese children.
- To provide data that can facilitate early diagnosis and intervention strategies for FC in this population.
Main Methods:
- A descriptive cross-sectional study was conducted over six months (July-December 2023) at a tertiary hospital.
- Included 241 children aged 1-15 years meeting Rome IV criteria for functional constipation.
- Demographic and clinical data were collected and analyzed using STATA13.
Main Results:
- 81.74% experienced hard or painful stools; 40.66% exhibited stool-withholding behavior.
- Associated symptoms included abdominal pain (66.79%), decreased appetite (39.00%), and gastroesophageal reflux (34.44%).
- Rectal bleeding (21.16%), urinary incontinence (10.91%), and a family history of constipation (29.46%) were also noted.
Conclusions:
- Functional constipation is a significant pediatric gastrointestinal disorder with diverse clinical presentations.
- Early identification and management are essential for improving outcomes and preventing complications in affected children.
Introduction:
Pooled global prevalence of functional constipation is 14.4% based on Rome IV criteria. The condition often arises from voluntary withholding of faeces due to fear of painful defecation leading to symptoms such as infrequent and painful bowel movements, faecal incontinence, retentive posturing, and urinary complications. The data on functional constipation from developing nations like Nepal remain scarce. This study aims to find out sociodemographic and clinical characteristics of functional constipation among Nepalese children thereby facilitating early diagnosis and intervention strategies to mitigate its impact.
Methods:
A descriptive cross-sectional study was carried out over a six-month period, from 1st July to 30th December, 2023, at a tertiary-level hospital with sample size of 241. Children aged 1-15 years meeting the Rome IV diagnostic criteria for functional constipation were included in the study. Demographic information along with clinical history was collected and analysed using STATA13.
Results:
Hard stools or painful bowel movements were reported in 197 (81.74%) children, stool-withholding behavior in 98 (40.66%), and fecal incontinence in 37 (16.18%). Other associated symptoms included abdominal pain in 161 (66.79%), decreased appetite in 95 (39.00%), and gastroesophageal reflux in 83 (34.44%) cases. Rectal bleeding was observed in 51 (21.16%) and urinary incontinence in 26 (10.91%) children. A family history of constipation was noted in 71 (29.46%) cases.
Conclusions:
Functional constipation is a prevalent paediatric gastrointestinal disorder, significantly impacting a child's quality of life. Early recognition and intervention are crucial to prevent complications and enhance outcomes.
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