# Prevalence of Functional Constipation in Children with Down Syndrome: A Study Conducted at a General Pediatrics Service

## TL;DR

This study finds that over 40% of children with Down syndrome suffer from functional constipation, highlighting the need for targeted care protocols.

## Contribution

The study identifies a high prevalence of functional constipation in children with Down syndrome and links it to delayed sphincter training.

## Key findings

- 41.7% of children with Down syndrome in the study had functional constipation.
- Functional constipation was associated with delayed sphincter training and hardened stools.
- Most children achieved bowel control when toilet training started after 30 months.

## Abstract

Background/Objectives: Gastrointestinal and eating disorders are highly prevalent problems in children with Down syndrome (DS) and have a significant impact on their daily lives. It is important to investigate the bowel habits of children with DS, specifically the prevalence of functional constipation (FC), in order to develop practice guidelines for pediatricians that support diagnosis and treatment. Materials and Methods: This observational, analytical, and cross-sectional study was approved by the Ethics Committee and included 36 children with DS under pediatric outpatient follow-up at a university hospital. To assess bowel habits, an interview was held with the parents using the Rome IV criteria and the Bristol Stool Scale. The children were divided into two groups: those with and those without FC. Specific curves for individuals with DS were used for nutritional assessment. Results: The median age of the children was 46.6 months (5 to 144 months); a total of 80.5% of those included were eutrophic. The median age at initiation of toilet training was 36 months. Most children achieved bowel control when training started after 30 months of age. A total of 15 (41.7%) of the 36 children included were assigned to the group with FC, and 21 (58.3%) were assigned to the group without FC. The FC group had a lower frequency of bowel movements, hardened stools, pain during bowel movement, and used laxatives. According to the Rome IV criteria, the three most prevalent criteria were hard stools, large-volume stools, and painful bowel movements. Conclusions: Children with DS had a high prevalence of FC, and it was possible to identify an association between delayed sphincter training and FC. A care and monitoring protocol and flowchart are useful tools for the general pediatrician.