Review Of Functional Constipation in Pediatric Age Group: A Retrospective Study
(Arabic Bord of general surgery) M. B. Ch. B. C. A. B. S / Department of general surgery, Al-Kadhimian Medical City, Baghdad, Iraq.
(Arabic Bord of general surgery) M. B. Ch. B. C. A. B. S/ Department of general surgery, Al-Kadhimian Medical City, Baghdad, Iraq.
(Iraqi board of general surgery) M. B. Ch. B. F. I. C. M. S. D. G. S. / Department of general surgery, Al-Kadhimian Medical City, Baghdad, Iraq.
BACKGROUND: Constipation is one of the common disorders of childhood across the world. It is an issue for both the patient and family. Functional constipation easily diagnosed clinically and early intervention by family education, dietary habits manipulation, toilet training and laxative medication may induce complete resolution. OBJECTIVE: The aim of this study is to review and analyze the etiological factors, age, gender, demographic and socioeconomic status and also to review the treatment of functional constipation to assist the medical care providers in the management of constipation in the pediatric age patients in our country due to lack of literature and misunderstanding of the pathophysiology of functional constipation. METHODS: A total 128 consecutive children aging from 1 to 13 years, all with functional constipation, and any case associated with underling disease (organic constipation) were excluded, were reviewed and analyzed with related factors including age, gender, demographic, and socioeconomic status. Treatment was assessed with fallow up for 6 to 9 months in Al-Kadhimain Medical City, Baghdad, Iraq, from June 2018 to June 2021. RESULTS: A total of This study group were 128 patients, ages from 1 to 13 years and the mean age were 5.1 years, girls were slightly more than boys, female 72 (56.25%) and male 56 (43:75%), female to male ratio 1.28:1, the Peak incidence of constipation occurs at the early childhood preschool age: 57 (44.53%) patients aged from 3 to 5 years. 84 (65.62%) patients live in urban areas and 44 (34.38%) live in rural community. 79 (61.71%) patients came from families with low socioeconomic status. The commonest presenting feature was painful defecation, 109 (85.15%) presents with painful stool, and 98 (76.56%) patients complaining of episodes of fecal incontinence (encopresis) and 117 (91.40%) patients with history of low dietary fiber and fluid intake. The treatment was highly effective by education, dietary manipulation, behavioral changes, toilet training, and laxatives with close regular follow up in 113 (88.28%) patients but 15 (11.72%) patients had frequent relapse that need aggressive treatment. CONCLUSIONS: Functional constipation is common problem in children and most of the patients were cured by proper management. Variable times were required for the treatment and relapses are frequent. Education of the parents, dietary manipulation, toilet training, laxatives and proper follow up is the main issue in the management.