The effects of lifestyle changes like diet, toilet habits, physical activity and others in children with functional constipation

Authors

  • Pankaj Kumar Singhal Department of Paediatrics J. K. Lon Hospital Associated with Government Medical College, Kota, Rajasthan, India
  • Peeyush Gupta Department of Paediatrics, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India
  • Madhu Mathur Department of Paediatrics, Mahatma Gandhi Medical College, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20233237

Keywords:

Constipation, Lifestyle, Fibers rich diet, Junk Food, Physical activity, Toilet habits

Abstract

Background: Functional constipation is common in pediatric age group. Our aim is to evaluate the effects of lifestyle changes (diet, toilet habits, physical activity and others) in children with functional constipation, and to assess the risk factors of functional constipation in Indian children.

Methods: This was an observational, prospective, questionnaire and proforma based (pretested and predesigned) follow-up study. Duration was from January 2016 to December 2017. Study was conducted at, department of paediatrics, Mahatma Gandhi Medical College, Jaipur.

Results: On regular follow-up, stool frequency was improved after changing the lifestyle factors like adequate physical activity (p<0.05, CI: 0.27) and regular toilet habits (p<0.05, CI:0.93), blood/mucus, straining, painful defecation and pain abdomen, all are showing significant improvement (p<0.05) after relieving constipation. On regular follow-up Need of disimpaction (polyethylene glycol or proctoclys enema) reduced significantly (p=0.001), number of cases with adequate fiber diet improved significantly (p=0.001), Number of children consuming frequent junk food decreased significantly (p=0.001).                                

Conclusions: Initial disimpaction, if needed and maintenance laxative therapy (1-3 months as per need) along with major lifestyle changes like fibers rich diet, avoidance of junk food, adequate physical activity, optimal sleep hygiene, and daily regular toilet habits have significantly positive correlation with improvement in functional constipation and its symptoms.

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References

Fiorino KN, Liacouras CA. Nelson textbook of pediatrics. 20th ed. USA: Elsevier; 2012:2;1807.

Hyams J, Colletti RB, Faure C. Functional gastrointestinal disorders. J Pediatr Gastroenterol Nutr. 2002;35(1):110-7.

Caplan A, Walker L, Rasquin A. Validation of the pediatric Rome II criteria for functional gastrointestinal disorders using the questionnaire on pediatric gastrointestinal symptoms. J Pediatr Gastroenterol Nutr. 2005;41:305-16.

Voskuijl WP, Heijmans J, Heijmans HS, Taminiau JA, Benninga MA. Use of Rome II criteria in childhood defecation disorders: applicability in clinical and research practice. J Pediatr. 2004;145:213-7.

Mugie SM, Lorenzo CD, Benninga A. Constipation in Childhood. Nat Rev Gastroenterol Hepatol. 2011;8: 502-11.

Herz MJ, Kahan E, Zalevski S, Aframian R, Kuznitz D, Reichman S. Constipation: a different entity for patients and doctors. Fam Pract. 1996;13(2):156-9.

van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol. 2006;101(10):2401-9.

Del Ciampo IR, Galvão LC, Del Ciampo LA, Fernandes MI. Prevalence of chronic constipation in children at a primary health care unit. J Pediatr. 2002; 78(6):497-502.

Olaru C, Diaconescu S, Trandafir L, Gimiga N, Stefanescu G, Ciubotariu G, Burlea M. Some risk factors of chronic functional constipation identified in a pediatric population sample from Romania. Gastroenterol Res Pract. 2016.

Morais MB, Vitolo MR, Aguirre ANC. Measurement of low dietary fibre intake as a risk factor for chronic constipation in children. J Pediatr Gastroenterol Nutr. 1999;29:132-5.

Speridião PG, Tahan S, Fagundes-Neto U, Morais MB. Dietary fiber, energy intake and nutritional status during the treatment of children with chronic constipation. Braz J Med Biol Res. 2003;36(6):753-9.

Maffei HVL, Moreira FL, Kissimoto M. História clínica e alimentar de crianças atendidas em ambulatório de gastroenterologia pediátrica (GEP) com constipação intestinal crônica funcional (CICF) e suas possíveis complicações. J Pediatr. 1994;21:57.

Loening-Baucke V. Prevalence, symptoms and outcome of constipation in infants and toddlers. J Pediatr. 2005;146(3):359-63.

Kokkonen J, Haapalahti M, Tikkanen S, Karttunen R, Savilahti E. Gastrointestinal complaints and diagnosis in children: a population-based study. Acta Pædiatr. 2004;93:880-6.

Sujatha B, Velautham RD, Deivamani N, Bevanandam S. Normal bowel pattern in children and dietary and other precipitating factors in functional constipation in children. JCDR. 2015;9(6):SC12-5.

Di Lorenzo C, Benninga MA. Pathophysiology of Paediatric Fecal Incontinence. Gastroenterology. 2004; 126(1):33-40.

Wu TC, Chen LK, Pan WH, Tang RB, Hwang SJ, Wu L, et al. Constipation in Taiwan elementary school students: a nationwide survey. J Chin Med Assoc. 2011;74(2):57-61.

Andersson H, Bosaeus I, Falkheden T, Melkersson M. Transit time in constipated geriatric patients during treatment with a bulk laxative and bran: a comparison. Scand J Gastroenterol. 1979;14:821-6.

Painter NS and Burkitt DP. Diverticular disease of the colon: a deficiency disease of western civilization. Br Med J. 1971;2:450-4.

Huang R, Ho SY, Lo WS, Lam TH. Physical activity and constipation in Hong Kong Adolescent. PLoS One. 2012;9(2):e901.

Chien L-Y, Liou YM, Chang P. Low defaecation frequency in Taiwanese adolescents: Association with dietary intake, physical activity and sedentary behaviour. J Pediatr Child Health. 2011;47:381-6.

Blundell JE, Stubbs RJ, Hughes DA, Whybrow S, King NA. Cross talk between physical activity and appetite control: does physical activity stimulate appetite?. Nutr Soc J. 2003;62:651-61.

Murakami K, Okubo H, Sasaki S. Dietary intake in relation to self-reported constipation among japanese women aged 18-20 years. Eur J Clin Nutr. 2006;60: 650-7.

Campbell AJ, Busby WJ, Horwath CC. Factors associated with constipation in a community based sample of people aged 70 years and over. J Epidemiol Community Health. 1993;47:23-6.

Vieira MC, Negrelle IC, Webber KU, Gosdal M, Truppel SK, Kusma SZ. Pediatrician's knowledge on the approach of functional constipation. Rev Paul Pediatr. 2016;34(4):425-431.

Mouterde O. Constipation in infants and children: How should it be treated? Arch Pediatr. 2016;23(6):664-7.

Dziechciarz P, Wojtyniak K, Horvath A, Szajewska H. Enema versus polyethylene glycol for the management of rectal faecal impaction in children with constipation - a systematic review of randomised controlled trials. Prz Gastroenterol. 2015;10(4):234-8.

Van Ginkel R, Reitsma JB, Buller HA, Van Wijk MP, Taminiau JA, Benninga MA. Childhood constipation: longitudinal follow-up beyond puberty. Gastroenterology. 2003;125:357-63.

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Published

2023-10-26

How to Cite

Singhal, P. K., Gupta, P., & Mathur, M. (2023). The effects of lifestyle changes like diet, toilet habits, physical activity and others in children with functional constipation. International Journal of Contemporary Pediatrics, 10(11), 1673–1679. https://doi.org/10.18203/2349-3291.ijcp20233237

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Original Research Articles