Fecal Impaction Research Articles

Parents' Knowledge, Attitude, and Practice Related to Childhood Constipation in Makkah, Saudi Arabia.

Introduction Functional constipation in children is described as irregular or difficult bowel motions without underlying systemic or anatomical causes. Although constipation can have a serious negative impact on a child's health and the lives of their parents. This study aimed to assess the knowledge ofparents about childhood constipation, intending to reduce morbidity and mortality through increased public health education in Makkah, SaudiArabia. Methods The current study was a web-based, descriptive cross-sectional study. The data were obtained from May 2023 to November 2023 through an online questionnaire directed to parents in Makkah, Saudi Arabia, and analyzed using SPSSversion 27.0.1 (Armonk, NY: IBM Corp.). Results A total of 796 participants were included in the present study, of which205 (25.8%) were malesand 591 (74.2%) were females.The knowledge levels among them varied, with 11.1% correctly defining constipation and 63.6% recognizing it as a symptom. Common causes like organic and functional constipation were acknowledged by 88.4% and 81.3% of participants, respectively. Regarding practices, 27.9% recommended high-fiber foods for initial home treatment, and 42.8% acknowledged that an enema is effective for fecal impaction. In the dietary recommendations, 71.7% suggested fruits and 68.8% mentioned vegetables. Concerning attitudes, 65.1% expressed fear of childhood constipation continuing into adulthood, while 30.9% feared severe medical conditions. The internet (25.5%) and friends/relatives (23.6%) were the primary sources of information. Knowledge was significantly higher among females and those with postgraduate education. Conclusion This study highlights the variability in knowledge levels among parents, with an overall moderate understanding of childhood constipation. It emphasizes a moderate level of adherence to recommended practices related to childhood constipation, with some room for improvement in Makkah, Saudi Arabia.

Polyethylene Glycol 4000 for Fecal Disimpaction in Cerebral Palsy Children.

This study evaluated the efficacy of Polyethylene glycol 4000 for fecal disimpaction in children with cerebral palsy. A randomized control trial study was conducted on children with cerebral palsy between February - March 2017 in the pediatric neurology outpatient clinic Dr. Soetomo Hospital. Children aged 2-16 years with fecal impaction randomly assigned into polyethylene glycol 4000 (PEG 4000) and saline enema group. Polyethylene glycol 4000 was given at a dosage of 0.7 g/kg and enema using normal saline 15ml/kg twelve hourly. Constipation was diagnosed using ROME IV criteria, and abdominal palpation identified fecal impaction. Efficacy was evaluated by clinical observation and adverse symptom monitoring. Data were analyzed by statistical software using an independent t-test (p<0,05). Thirty-two children were randomized into the study. Muscle relaxant was discovered in 17/32 patients. Sex, age, and body weight were not statistically different between groups. The resolution of fecal impaction was significantly different between PEG 4000 and saline enema (21.69 hours and 39 hours respectively; p=0.001). Application of muscle relaxant and severity of the disease did not involve treatment efficacy. There was no adverse symptom reported during treatment. Polyethylene glycol 4000 results in fecal disimpaction faster than enema in constipated children with cerebral palsy.

Scoring system to evaluate meaningful fecal impaction in patients with lower urinary tract dysfunction with simple radiography (KUB).

The management of bowel bladder disorder (BBD) has only been indicated for subjective constipation without objective evidence. We attempted to highlight the radiological findings in patients with BBD and construct a scoring system to identify patients with BBD prior to treatment. Forty-five patients with lower urinary tract dysfunction (LUTD) received polyethylene glycol for 2 months before bladder medication for LUTD. Based on partial response to LUTD following treatment, we divided the patients into LUTD-fecal impaction (FI) and LUTD not attributed to FI (LUTD-NFI) groups. Pre/post-treatment kidney, ureter, and bladder (KUB) were compared with respect to several radiographic parameters. Items with significant changes after treatment were included in the scoring system. The accuracy and inter-rater agreement were also evaluated. Cecal dilation, descending colon dilation, fecal quality, and overall haziness were found to undergo significant changes after laxative treatment. We assigned 0 to 2 points for each item, with a total score of 8. Receiver operating characteristic curve analysis revealed a cutoff value of 5 between LUTD-FI and LUTD-NFI, with 79% sensitivity and 88% specificity. The scoring system was instructed to six doctors who were unaware of it and was then tested on previous patients, which showed a substantial concordance rate (κ=0.79, p<0.05). Fecal scoring system based on KUB was beneficial in identifying children with LUTD attributed to FI. This may provide an opportunity to obtain objective FI data as an alternative to subjective assessment of constipation.

Impacts of human and herbivorous feces on lake surface sediments of the Tibetan Plateau based on fecal stanol proxies

Lake ecosystems on the Tibetan Plateau (TP) are highly susceptible to external input owing to their fragile environment. However, less study has been done to focus the direct influences of anthropogenic activities on the lake sediments by human activities. In this study, we performed the first large-scale investigation to use the fecal stanol proxies in lake surface sediments to assess the impact of human and herbivorous feces on TP lakes. The 75 investigated lakes were divided into three types (I, II, and III) according to cluster analysis of the fecal stanol ratios R1′ and R2′. Fecal stanols in type I lake surface sediments originate from a mixture of herbivorous and human feces; fecal stanols in type II lake surface sediments primarily originate from herbivorous feces with minimal human feces. In contrast, fecal stanols in type III lake surface sediments are mainly derived from herbivorous feces (coprostanol concentration > 100 ng/g), a mixed source of herbivorous feces and cholesterol reduction (coprostanol concentration of 10–100 ng/g), and in situ reduction of cholesterol (coprostanol concentration < 10 ng/g). Among the TP lakes investigated, 9 % had significant fecal contamination, 48 % had moderate or slight fecal contamination, and 43 % were uncontaminated. Domestic animal feces were the main source of fecal stanols in the surface sediments of moderately and slightly contaminated lakes in the central TP. There were 9 % of investigated lakes with significant fecal contamination from human and herbivorous feces; in contrast, 52 % of investigated lakes did not definitely show the presence of human fecal matter. This study has important implications for fecal contamination assessment in lake ecosystems and provides a reference for early herbivorous change and paleo-human activity research.

Application of a new-type of defecator in the treatment of rectal fecal impaction

Objective: This study aimed to investigate the viability and safety of a novel defecator in managing rectal fecal impaction. Methods: In a descriptive case series, this new defecator was administered to constipated individuals among the ages of 18 and 80 years who met the diagnostic criteria for rectal fecal impaction and were identified with acute rectal fecal impaction through CT scans. The contraindications for this defecator included: (1) Anal stenosis, acute intestinal obstruction, and intestinal perforation; (2) Concomitant rectal malignant tumors; (3) Coagulation dysfunction, low platelet counts, gastrointestinal bleeding, or other bleeding risks; (4) Patients with severe underlying conditions affecting the heart, brain, lungs, or other systems; (5) Individuals with mental health disorders. Based on these criteria, clinical data from 42 patients with rectal fecal impaction who underwent treatment with the new defecator at Deyang People's Hospital between July 2020 and April 2023 were retrospectively analyzed.The defecator comprises three components: a head, a spiral rod, and a handle, constructed from disposable stainless steel wire. The treatment procedure involves the following steps: The patient assumes a flexed, supine position on their left side with their buttocks slightly protruding from the bed's edge. A transparent sealing bag is affixed to the buttocks, centered around the anus. With gloved hands inserted through the bag's entrance, a cotton ball soaked in liquid paraffin lubricates the anal canal and the head of the defecator's spiral rod. The defecator is then slowly rotated and inserted into the anus, with careful attention to any changes in resistance. Once the spiral rod is fully inserted, the patient is instructed to inhale and defecate while the defecator is slowly withdrawn, carrying the dislodged fecal matter, and depositing it into the sealed bag. This operation is repeated 2 to 3 times, followed by the injection of either 100 ml of 36°C normal saline or 60 ml of liquid paraffin into the rectum. After a 5 to 8-minute wait, the patient assumes a squatting position to expel any remaining feces from the rectum. The study assessed the operation time, single treatment success rate, pain levels during treatment, and the occurrence of complications. Results: All 42 patients successfully underwent treatment with the new defecator device, achieving a single treatment success rate of 100%. The average operation time was 11.0 minutes (range: 9.0 to 13.3 minutes). During treatment, 20 cases (47.6%) reported moderate to severe anal pain, with 1 case (2.4%) experiencing anal fissure bleeding, and 6 cases (14.3%) reporting discomfort such as palpitations and sweating. No serious complications, including rectal perforation, were observed in any case. Conclusion: The new defecator device demonstrates ease of use and safety, making it a feasible option for treating acute rectal fecal impaction.

Laporan Kasus : Prolaps Kloaka pada Kura Sulcata (Geochelone sulcata)

Cloacal prolapse is a protrusion of the tissues in the cloaca out of the body, so that the mucosa of the cloaca is visible. Cloacal prolapse in turtles can be caused by faecal impaction caused by ingestion of foreign bodies such as sand, bark, or gravel, dystocia, intestinal parasitism, cloacalith, uroliths, neoplasia, space-occupying lesions in the coelomic cavity and foreign body damage. A sulcata tortoise named Kardun is 2 years old, weight 1.17 kg, with complaints of weakness, prolapse from yesterday, does not want to eat and drink, feeds are often given hibiscus and cactus, type of outdor treatment and there are urates discharge. The diagnosis is based on the results of X-ray examination and blood tests. Before the operation, the sulcata tortoise was injected with local anesthesia using lidocine 0.11 ml, a dose of 0.11 mg/kg and after the operation, an injection of the antibiotic Enrofloxacin 0.07 ml, a dose of 5-10 mg/kg, Dexamethasone 0.05 ml, a dose of 2-4 mg/kg, Multivitamin Vigantol® 0.1 ml dose 0.06-0.1 mg/kg.

Relief from behind: enemas, the back door enforcement to help treating chronic constipation in adults

ABSTRACT Introduction Chronic constipation is a frequent symptom encountered in the daily clinical practice. The treatment of this condition mainly relies on the use of laxatives. However, patients’ satisfaction with this approach is limited, and alternative measures are often added to the treatment. Among these, particularly frequent worldwide is the use of enemas, even though literature data on its scientific validity are scarce. Areas covered In this article, by an extensive online search of Medline (through PubMed), Scopus, Cochrane CENTRAL, EMBASE, and the Science Citation Index, the available literature data on the use of enemas in adult patients with chronic constipation, also in the perspective of available guidelines on treatment of this pathological condition, were analyzed. Expert opinion Although the use of enemas remains a frequently employed method and it is considered as useful by many physicians as an adjunctive support for the treatment of chronic constipation in adults, this practice is not substantiated by rigorous scientific data, and some studies are available only for specific instances (fecal impaction, transanal irrigation). Thus, waiting for more robust scientific data, enemas treatment should be carried out on an individual patient’s basis, according to the experience of the caring physicians.

An Unusual Case of Loperamide Toxicity in a Neonate - A Case Report

Introduction: Loperamide is an antidiarrheal agent approved by the Food and Drug Administration for the treatment of various forms of diarrhea in adults, including traveler’s diarrhea, irritable bowel syndrome associated with chronic diarrhea, and acute nonspecific diarrhea in patients 2 years of age and older, and reducing ileostomy output. The drug has, however, been shown to be toxic at therapeutic doses and causes serious cardiac adverse reactions, central nervous system (CNS) effects such as decreased level of consciousness, coordination abnormality, muscular hypertonia, miosis, respiratory depression, urinary retention, paralytic ileus, abdominal distension, and fecal impaction in infants and toddlers. Methods: We report an unusual case of suspected loperamide toxicity in a 22-day-old baby who presented with respiratory and CNS depression after consuming a single therapeutic dose of loperamide. Results: The neonate’s respiratory depression was attributed to ingestion of loperamide, prescribed by a local quack, as all other causes were ruled out. There was a significant improvement in the baby’s respiratory efforts after IV naloxone, an effective antidote. Conclusion: Special caution should be taken when administering loperamide to pediatric patients due to their greater variability in response. Loperamide is often given by local quacks as a nonprescription medicine for immediate relief, even to infants and toddlers, without complete knowledge about its potential side effects at therapeutic doses. To address this, it is imperative that strict measures should be taken.

Surgical intervention for the correction of fecal impaction in an obstipated cat with an old compression injury in the lumbosacral region of the spine

BackgroundFeline obstipation is a clinical condition often manifested by defecation inability that results in fecal impaction. This is frequently associated with a blunt traumatic injury that affects mostly the spine and surrounding structures in the caudal part of the back leading to vertebral compression.Case presentationA 6-month-old, female, mixed-breed cat of 1.49-kg BW was presented with a history of prolonged constipation (i.e., obstipation) along with discomfort and weakness. Prior to the presentation, the cat was medically treated with dietary fibers, fecal softeners, and enemas, but obstipation persisted. Clinical examinations revealed that there was straining but not effective for defecation. In addition, the cat had poor appetite and dehydration, electrolyte abnormalities, and defects in posture and gait. The lumbosacral region showed a depression that was supposed to be the consequence of an old, untreated regional injury. Radiographic imaging indicated a marked ventral curvature in the lumbosacral spine including major deviations in the positions of the L6 and L7 vertebrae and the sacrum as well. A firm tubular structure was felt on ventral abdominal palpation, and further ultrasonography revealed the tubular impaction. Laparotomy exposed a definite large bowel impaction, and enterotomy was performed to evacuate the firm feces. Postoperatively, supportive medications and care were provided for better recovery. However, the impaction recurred within 3 months after surgery, and euthanasia was a further choice.ConclusionsTraumatic injuries involving the lumbosacral spine in cats might be serious enough to lead to severe constipation and thereby bowel impaction. Therefore, treatment should be prompt and accurate in any case of spinal injury to avoid further complications.

Gastrointestinal bezoars. Review of the literature and report of a rare case of pumpkin seed rectal impaction.

In science, bezoar is a mass of hair or undigested vegetable matter, found in a human or animal's intestines, similar to a hairball. Usually, it is found trapped in every part of the gastrointestinal system and must be distinguished by pseudobezoar which is an indigestive object voluntarily introduced into the digestive tract. The term Bezoar is from Arabic bāzahr, "bezoar" or ultimately from Middle Persian p'tzhl pādzahr, "antidote, bezoar"ægagropile o egagropile It should be a universal antidote that works against any poison, and could neutralize any poison. Otherwise, the name could derive from a kind of Turkish goat whose name is just bezoar. Authors report a case of fecal impaction by pumpkin seeds bezoar with abdominal pain: a difficulty to void with subsequent rectal inflammation and hemorrhoid enlargement was observed. The patient underwent a successful manual disimpaction. Guidelines do not require IRB approval Authors examined the literature about occlusion from bezoar The most common causes of occlusion from bezoar are: a previous gastric surgery such as a gastric band (for weight loss) or gastric bypass, a reduced stomach acid (hypochlorhydria) or decreased stomach size, a delayed gastric emptying, typically due to diabetes, autoimmune disorders, or mixed connective tissue disease. Seed bezoars are usually found in the rectum of patients without predisposing factors, causing constipation and pain. Rectal impaction is common after ingestion of seeds while a true occlusion is rare. Although several cases of phytobezoars composed of various types of seeds are reported in literature, bezoars of pumpkin seeds have rarely been reported.

Faecal Impaction of the Elderly: a Review of the Existing Literature

Faecal Impaction of the Elderly: a Review of the Existing Literature

Fecal Impaction and Nonperforated Stercoral Colitis: Red Flags for Poor Outcomes.

Fecal impaction and stercoral colitis are common, yet little research has been performed on the associated mortality risk.We performed a retrospective cohort study of 970 hospital encounters representing 885 unique patients in which fecal impaction or stercoral colitis was identified in CT reports.Among the 535 patients with fecal impaction, 13.3% died or were discharged to hospice, compared to 13.1% among the 428 patients with nonperforated stercoral colitis (p = 0.93). Of the seven patients with perforation, five died or were discharged to hospice. The risk of death or discharge to hospice for patients with fecal impaction or nonperforated stercoral colitis aged 18-49 was 2.9% and rose approximately 4% each decade thereafter to 21.9% for patients 90 and older (p< 0.001). Patients with a body mass index of 25-30 had an 8.1% risk of death or discharge to hospice, compared to 23.4% for those with a BMI < 18.5 (p< 0.001). Patients with at least one ICD-10 code for dementia, paralysis/neuromuscular disease, or malnutrition/failure to thrive had a risk of death or discharge to hospice of 21.6%, compared to 1.9% among patients with none of these risk factors (p< 0.001). ICD-10 codes for sepsis were associated with 90.0% of the deaths and 44.3% of the discharges to hospice. Patients diagnosed in less than three hours had a risk of death or discharge to hospice of 8.0%, compared to a risk of 20.1% for those diagnosed in ≥ 12 hours (p< 0.001).

Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes.

Stercoral colitis is inflammation of the bowel wall caused by fecal impaction. Despite reported high morbidity and risk of perforation, little research assessing outcomes is available. This study characterizes the presentation, management, and outcomes of emergency department patients with stercoral colitis. We performed a retrospective chart review of ED patients with stercoral colitis identified on computed tomography (CT) scan. Of 814, 522 visits to multiple EDs across the US, 269 met the inclusion criteria. Variables regarding patient presentation, management, and outcomes were extracted from electronic medical records. Results were analyzed with percentages and 95% confidence intervals (CIs). Of 269 patients, the median age was 76 years. The most common chief concern was abdominal pain/distension (33.8%). However, abdominal pain was documented as absent in 62.1% of cases. The most common CT findings included fecal impaction (96.7%), bowel wall inflammation (72.9%), and fat stranding (48.3%). Eighty-four (31.2%) patients were discharged home from the ED, and over half of these (45/84, 53.6%) received no enema, laxatives, or disimpaction. Overall, 9 patients (3.3%, 95% CI 1.6% to 6.5%) required surgical management of a related complication within 3 months, 27 (10.0%, 95% CI 6.8% to 14.4%) returned to the ED within 72 hours, and 9 (3.3%, 95% CI 1.6% to 6.5%) died from a cause related to stercoral colitis within 3 months. Patients with stercoral colitis often present in a nonspecific manner, and short-term mortality is substantial. In this study, most discharged patients did not receive recommended treatment. This represents the largest ED study of stercoral colitis and provides further evidence linking this diagnosis with adverse outcomes.

Non-standard approach to infants and children with megacolon: laparotomy and endorectal pull-through for diagnosis and treatment in difficult countries with low resources in a non-profit setting: return to the past Soave's ERPT.

Hirschsprung's disease is an important cause of pediatric constipation with high risk of bacterial enterocolitis. Its diagnosis is histological and the suction biopsy is the gold standard. In resource-limited countries, the main diagnostic exam is the contrast enema and mini-invasive surgery lacks. We present the management of a cohort of patients with megacolon in Haiti, a low-resource country. Children with megacolon and fecal impaction admitted at St Damien Children Hospital in Port-Au-Prince in June, August and December 2017 were included. We considered only patients with an evident transition zone on contrast enema who underwent endorectal pull-through (ERPT). Short term complications were recorded. Twenty children with clinical megacolon were admitted, eleven were included in the study. No suction rectal biopsy and intraoperative histological evaluation were performed. In ten children a Soave ERPT with anastomosis at 5POD was performed, in the other case a Boley primary anastomosis was preferred. One patient complicated with a peritonitis. No major complications were recorded. Colostomy was not considered a good option. In developing countries, Soave ERPT with definitive anastomosis after few days could be considered a valid option. Colostomy is suggested only in case of scant general conditions or bad colon appearance.

Comparative efficacy of polyethylene glycol 3350 monotherapy against polyethylene glycol 3350 plus sodium picosulfate combined therapy in treating fecal impaction in pediatric functional constipation patients

Background: Functional constipation (FC) is a common pediatric problem worldwide. The management of FC comprises of a short initial disimpaction phase followed by long-term maintenance phase. Currently, polyethylene glycol (PEG) is considered as standard disimpaction therapy in pediatric FC patients. The aim of our study was to compare the efficacy of polyethylene glycol 3350 monotherapy with polyethylene glycol 3350 and sodium picosulfate combined therapy in treating fecal impaction in pediatric FC patients. Methods: All children (aged &gt;1 year) diagnosed with FC as per ROME IV criteria and presenting to the out-patient department of pediatric gastroenterology, hepatology and nutrition unit of a tertiary health centre in north Indian Himalayan state were randomized into two open label, prospective, parallel groups, namely group A (receiving PEG 3350 monotherapy) and group B (receiving combined PEG 3350 plus sodium picosulfate therapy), over a period of 13 months. The outcome was evaluated as successful disimpaction with onset of loose/watery stools (Type-7 of Bristol stool chart scale). The success rates and mean time to disimpaction for two groups were computed and compared. Results: Eighty-one patients were randomized into two groups. The mean time to disimpaction was found to be significantly lower (p&lt;0.001) for group B (2.37±1.16 days) when compared to group A (4.00±1.43 days). There was successful resolution of impaction in both groups. No adverse events were reported in either group. Conclusions: Combined PEG 3350 and sodium picosulfate therapy significantly reduces the disimpaction time when compared with PEG 3350 monotherapy in pediatric population, however both the therapies appear similar in achieving successful disimpaction.

Giant faecaloma as a complication of neuroleptic treatment – case report.

A faecal impaction is a condition that is well known as a complication of long-term neuroleptic treatment. Rarely can provide life-threatening complications such as gastrointestinal obstruction. Long-term consolidation of faecal masses can lead to create a well-formed, hard intraluminal conglomerate (faecaloma). Fecaloma can be successfully conservatively treated. In some cases endoscopic methods may be effective. Rarely surgical treatment is required. Prophylaxis of faecal impaction is important to patients undergoing neuroleptic therapy. Indispensable is to monitor the patient's condition for constipation and obstruction of the gastrointestinal tract. In this case study, we want to present a case of a giant faecaloma, which appeared as a complication of neuroleptic treatment.

Adding fish waste to the diet of Iceland scallop Chlamys islandica: effects on feeding and reproductive ability

Organic enrichment from fish farming may impact benthic species and habitats in adjacent areas. Norwegian salmon farming is continuously growing, but, due to area conflicts and severe sea-lice problems in the western areas, growth of the industry is focused in the northern areas. Knowledge is scarce on how an increase in fish farming will impact Arctic and subarctic species and habitats. One such species is the Iceland scallop Chlamys islandica, distributed from the Lofoten Islands in Nordland County to the Varangerfjord in Troms and Finnmark County. To study the impact of fine-particle fish faeces on feeding and reproductive ability in adult Iceland scallop, particles &lt;41 µm of finfish waste were added to the diet. Effects were tested via short-term (weeks) feeding studies using 2 diets, 100% cultured algal species and a 50% mix of algae and fish waste. In addition, a 100% fish waste diet was used to study longer-term effects on reproductive ability (months). Feeding (% particle clearance and feeding rate) on the microalgae diet tended to be higher than that on the diet containing fish waste, but the difference was significant only in 2 out of 4 cases. We did not find any effect of diets on reproductive ability (gonad development and fatty acid profiles) of scallops. Lack of knowledge on sufficient food levels for gonad maturation in this species may have affected the results. We suggest that future work includes the transplant of scallops from a reference site to fish production sites and that investigations begin immediately after spawning early in scallop gonad development.

Dolichocolon in low-birth-weight infants in 7 cases

Dolichocolon is a congenital malformation characterized by an abnormally long and tortuous colon. It is a rather rare pathology, the lesion mechanism of which is not clear. The sigmoid is considered the most commonly affected part. Some authors believe that the disease is congenital, resulting from an impairment of the autonomous intestinal nervous mechanism, others believe that it is acquired secondary to constipation or dietary or endocrine deficiencies. The clinical picture is marked by the installation of a classic triad: chronic constipation, generalized abdominal distension, and abdominal pain. With the advent of X-rays and the barium enema, these abnormalities are easily recognized. An unprepared abdomen may show aerocolia with the presence of fecal impaction. A barium enema, is usually sufficient to conclusively confirm the abnormality. Many patients require only symptomatic treatment of constipation. Surgical treatment is reserved for special cases. Our work, concerns patients hospitalized at the national reference center in neonatology at the children's hospital of rabat during the year 2021-2022. The study concerns seven cases who were hospitalized at day 1 of life for respiratory distress and in whom the diagnosis of dolichocolon was made after the observation of the clinical picture of this pathology.

Fecal impaction in adults.

Fecal impaction is a common digestive disorder and is considered an acute complication of chronic and untreated constipation. Generally, the factors responsible for fecal impaction are similar to those associated with constipation. Early identification and treatment minimize complications and patient discomfort. Common treatment options to address fecal impaction of the rectum include manual disimpaction or fragmentation, the use of distal and/or proximal softening or washout procedures such as enemas and suppositories, and oral or nasogastric tube placement for the administration of polyethylene glycol solutions containing electrolytes. In severe cases, surgical intervention is necessary. Post-treatment evaluation should include a colonic evaluation by flexible sigmoidoscopy, a colonoscopy, or a barium enema after the fecal impaction resolves. Following treatment, conduct an evaluation of causes and create a preventive therapy plan.

Epidemiological, Clinical, and Diagnostic Aspects of Chronic Abdominal Pain in Children: A Study in Shahrekord, Iran

Background and aims: Due to the multi-factoriality of chronic abdominal pain (CAP) in children, this study aimed to assess the main etiologies for CAP in children and its main determinants in a sample of the community of affected children living in Shahrekord, Iran. Methods: This cross-sectional study was conducted on 400 children aged 3-14 years who were referred to a referral clinic in Shahrekord, Iran in 2022. Abdominal pain at least 3 times in 3 months, which disrupted daily activities, was the criterion for entering the study. A checklist was prospectively fulfilled by interviewing to assess different aimed data. Results: The majority of children complained of periumbilical pain as the main site of chronic pain, and other pain points were much less common. The main characteristics that provided grounds for suspecting this type of pain included right abdominal pain without clear justification, growth disorder, and severe vomiting. The most common definitive diagnosis was functional constipation, followed by chronic gastritis and fecal impaction. Conclusion: The occurrence of periumbilical pain, along with the occurrence of severe and frequent vomiting and growth failure can be considered diagnostic markers triad when suspecting the occurrence of CAP. The most common etiologies for such pains included functional constipation, chronic gastritis, and fecal impaction.