Evaluation and Management of Constipation in Children-Single Centre Study

Abstract

Background: Constipation in Indian children is on raising mode and most of it is functional; if search the figure in multiple literature constipation is a worldwide common problem in children. Developed and developing countries have equally distributed identified risk factors for constipation in both. The quality of life has affected in constipated patients and increases the mental stress of kids and parents. It also constitutes a challenge for healthcare systems and society by incurring significant burden of expenditure. All the factors specify that childhood constipation is turn up as a significant public health problem.Materials and methodology: Two hundred pediatric patients within two year of study period who presenting with history suggestive of constipation were studied in terms of age, gender, presenting complaints and duration of symptoms. Constipation was assessed by proforma based history and examination including Bristol stool chart in all these patients up to 12 years of age of either sex with history suggestive of constipation included in study were patients with acute abdomen and who not following the criteria of inclusion are excluded from study. Illustrative data were measured in term of qualitative and quantitative variables. Qualitative measures like sex, presenting complaints and presenting symptoms of constipation and stool pattern, percentages and frequencies were calculated and quantitative variables like age, percentages/mean/Standard Deviation (SD) were calculated.Objectives: Early diagnosis and effective treatment of constipation in children, Implementation of guidelines to provide a consistent, coordinated approach and to improve outcome for children and Compare it with the other similar studies.Results: Constipation occurs comparatively frequent among children and functional type of constipation is the most common cause of constipation in pediatric patients. Stool consistency, bowel frequency, large caliber hard and painful defecation are more tactful parameters in diagnose of constipation. Age group 0 to 4 year children's are more commonly affected and male dominance is perceptible in both functional and in organic (pathologic) constipation. Functional constipation (84.5%) is the most common type of constipation presenting in children, though up to 15.5% of patients may have an organic cause in whom history of delayed passage of meconium, presence of distension of abdomen, and fecal mass in rectum are the detectable point to an organic pathology. Children who are constipated may be associated with urinary tract infection.Conclusion: Early diagnosis, adequate therapeutic intervention, toilet training and regular follow up are of key importance in the management of childhood constipation. Most of the patients are functional constipation so that diagnosis can be only by proper history and physical examination; rarely required investigation. Surgical options need to be considered only when medical therapy fails.