DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20202627

Functional constipation in Bangladeshi children: experience of demography and probable risk factors from a tertiary care hospital

Md. Wahiduzzaman Mazumder, Maimuna Sayeed, Md. Benzamin, Mahfuza Chowdhury

Abstract


Background: Constipation is a common problem throughout childhood. It is important to be fully aware of the factors involved in developing constipation in children. There are few published articles on childhood constipation in Bangladesh. In this study, our aim was to evaluate demography and probable/potential risk factors for functional constipation in Bangladeshi children.

Methods: The study was carried out among 179 children from May 2018 to June 2019 in the department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU) both indoor and outdoor basis. Children with constipation who fulfilled the ROME III criteria were evaluated for demography and probable/potential risk factors of constipation.

Results: A total of 179 subjects were included in the final analysis. Among them, 54.75% were boys and 45.25% were girls. Constipation was found more in the age group above 5 years (56.42%), then in 2 to 5 years age group (33.52%) and lower in below 2 years of age (10.6%). Constipation was more among children living in urban area (55.3%) than in rural area (44.69%). Constipation was the presenting complaint in 76.54% subjects, other complaints were abdominal pain (47.49%), anorexia (24.02%), vomiting (19.56%). Diet low in fiber (72.63%) was found as the most common potential risk factor, other factors were ingestion of cow’s milk (32.96%), not having regular meals with parents (19.55%), consumption of junk foods (28.49%). Staying with grandparents (16.76%), living in hostel or madrasa / residential religious institute (5.03%), long period of academic activity, [homework (10.61%) / tutor and coaching (7.26%)], unhygienic toilet in school (6.14%) were also found to be probable associated factors in this study.

Conclusions: Functional constipation was found more in boy’s and above five year age group. Low dietary fiber, consumption of cow’s milk and junk food, unwillingness to use toilets in school, long time in academic activity, were found to be potential underlying risk factors of constipation.


Keywords


Constipation, Children, Epidemiology, Probable risk factors

Full Text:

PDF

References


Drossman DA. The functional gastrointestinal disorders and the Rome II process. Gut. 1999;45 Suppl 2:II1-5.

Kondapalli CS, Gullapalli S. Constipation in children: Incidence, causes in relation to diet pattern and psychological aspects. Int J Contemp Pediatr. 2018 Jan;5(1):6-13.

Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, van Tilburg M. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterol. 2016 May 1;150(6):1456-68.

Southwell BR, King SK, Hutson JM. Chronic constipation in children: organic disorders are a major cause. J Paediatr Child Health. 2005;41(1-2):1-15.

Garrigues V, Galvez C, Ortiz V, Ponce M, Nos P, Ponce J. Prevalence of constipation: agreement among several criteria and evaluation of the diagnostic accuracy of qualifying symptoms and self-reported definition in a population-based survey in Spain. Am J Epidemiol. 2004;159(5):520-6.

Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A, Walker LS. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterol. 2006 Apr 1;130(5):1527-37.

Hyman PE, Milla PJ, Benninga MA, Davidson GP, Fleisher DF, Taminiau J. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterol. 2006 Apr 1;130(5):1519-26.

Chan JS. A community-based study of the prevalence of constipation in young children and the role of dietary fibre. Hong Kong Med J. 2005 Dec;11(6):431-6.

Kajiwara M, Inoue K, Usui A, Kurihara M, Usui T. Micturation habits and prevalence of daytime urinary incontinence in Japanese primary school children. J Urol. 2004;171:403-7.

Ganinkou RE, Adamidis D, Gianniou M. Epidemiology of chronic constipation in greek children. Hell J Gastroenterol. 1999;12:58-62.

Khanna V, Poddar U, Yachha SK. Etiology and clinical spectrum of constipation in Indian children. Indian Pediatr. 2010 Dec 1;47(12):1025-30.

Sonnenberg A, Koch TR. Epidemiology of constipation in the United States. Dis Colon Rectum. 1989 Jan 1;32(1):1.

Bytzer P, Howell S, Leemon M, Young LJ, Jones MP, Talley NJ. Low socioeconomic class is a risk factor for upper and lower gastrointestinal symptoms: a population based study in 15 000 Australian adults. Gut. 2001 Jul 1;49(1):66-72.

Sandler RS, Jordan MC, Shelton BJ. Demographic and dietary determinants of constipation in the US population. Am J Public Health. 1990;80(2):185-9.

de Araújo Sant AM, Calçado AC. Constipation in school-aged children at public schools in Rio de Janeiro, Brazil. J Pediatri Gastroenterol Nutr. 1999 Aug 1;29(2):190-3.

Morais MB, Vitolo MR, Aguirre AN, Fagundes-Neto U. Measurement of low dietary fiber intake as a risk factor for chronic constipation in children. J Pediatri Gastroenterol Nutr. 1999;29(2):132-5.

Loening-Baucke V. Chronic constipation in children. Gastroenterology. 1993;105(5):1557-64.

Andiran F, Dayi S, Mete E. Cows milk consumption in constipation and anal fissure in infants and young children. J Paediatr Child Health. 2003;39(5):329-31.

Ozokutan BH, Zoroglu S, Ceylan H, Ozkan KU. Psychological evaluation of children with idiopathic constipation and their parents. Pediatricsinternational: Official J Japan Pediatric Soc. 2005;47(3):311-5.

Lundblad B, Hellstrom AL. Perceptions of school toilets as a cause for irregular toilet habits among schoolchildren aged 6 to 16 years. J School Health. 2005;75(4):125-8.

Vernon S, Lundblad B, Hellstrom AL. Children's experiences of school toilets present a risk to their physical and psychological health. Child: Care, Health, Development. 2003;29(1):47-53.

De Schryver AM, Keulemans YC, Peters HP, Akkermans LM, Smout AJ, De Vries WR, et al. Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scandinavian J Gastroenterol. 2005;40(4):422-9.

Elawad MA, Sullivan PB. Management of constipation in children with disabilities. Developmental Med Child Neurol. 2001;43(12):829-32.