Infant Dyschezia Is Associated With Increased Risk of Functional Constipation in Childhood: A Case-Control Study

Functional constipation (FC) frequently occurs in children and leads to notable discomfort as well as substantial healthcare costs. Infant dyschezia (ID) is characterized by excessive straining and crying before passing soft stools in infants and is traditionally considered benign and self-limiting. However, emerging evidence suggests a possible link between ID and later chronic bowel dysfunction. The objective of this work was to examine whether a history of ID is linked to the later emergence of FC during childhood.

We recruited 150 children for this case-control investigation, including 90 individuals diagnosed with FC and 60 healthy controls, all from a tertiary pediatric outpatient clinic. Diagnoses were based on Rome IV criteria. Data on demographics, infant feeding, family history of constipation, and history of ID were collected through structured interviews. We applied logistic regression analysis to determine which factors independently predicted FC.

Children with FC were significantly more likely than controls to have a history of ID (66.7% vs. 40.0%, p = 0.001). On multivariate analysis, ID remained independently associated with FC (OR = 2.75; 95% CI: 1.34-5.64; p = 0.006). Breastfeeding during infancy (either exclusive or partial) showed a protective effect (OR = 0.22; 95% CI: 0.09-0.56; p = 0.002). The FC group contained more boys (54.4% vs. 35.0%), but this difference was not statistically significant (p = 0.057).

These results indicate that ID could serve as an independent risk factor for childhood FC. Early recognition and parental guidance are essential to prevent mismanagement and long-term morbidity. Longitudinal studies are recommended to confirm causality and inform preventive strategies.