Rome IV Functional Constipation in Childhood: Early-Life Factors and Dietary Habits in a Southeast Asian Clinical...

Functional constipation (FC) is a prevalent paediatric condition that places a significant burden on healthcare systems and adversely impacts the quality of life of children. Despite its widespread occurrence, the underlying contributors to FC in early childhood remain inconsistently documented. Thus, the study aimed to assess the early life factors and dietary habits in the associations with FC in children aged 6-48 months.

This cross-sectional study recruited children undergoing routine health examinations in the City Children's Hospital. FC was diagnosed using the Rome IV criteria. Data were collected from caregivers by interview using questionnaires.

Among 344 children, 24.41% (n = 84) were diagnosed with FC, increasing to 31.71% in those aged 36.1-48 months. Low birth weight (< 2.0 kg) and preterm birth were independently associated with FC. Higher consumption of vegetables and fruits was significantly protective against FC, whereas increased intake of cheese (p_trend < 0.001) and soft drinks (p_trend < 0.001) was positively associated with FC risk. After adjustment for age, sex, and BMI z-score, frequent cheese consumption remained a risk factor (> 5 days/week: adjusted odds ratio (aOR) = 5.18, 95% CI: 1.58-16.93; 2-4 days/week: aOR = 3.10, 95% CI: 1.52-6.34), and daily fresh fruit intake was protective (aOR = 0.28, 95% CI: 0.14-0.59).

This study emphasises the critical influences of birth weight and gestational age on FC risk. Targeted interventions, including promoting fibre-rich fresh fruit consumption and limiting excessive cheese intake, are recommended to help prevent FC in young children.