Sociodemographic and Clinical Characteristics of Functional Constipation in Children Receiving Care at a Tertiary Hospital: An Observational Study

TL;DR

This study examines the sociodemographic and clinical features of functional constipation in children in Nepal to aid early diagnosis and treatment.

Contribution

The study provides new insights into functional constipation in Nepalese children, an understudied population in developing countries.

Findings

Most children experienced hard stools or painful bowel movements, with significant rates of stool-withholding behavior and fecal incontinence.

Common associated symptoms included abdominal pain, decreased appetite, and gastroesophageal reflux.

A notable proportion of children had rectal bleeding, urinary incontinence, and a family history of constipation.

Abstract

Pooled global prevalence of functional constipation is 14.4% based on Rome IV criteria. The condition often arises from voluntary withholding of faeces due to fear of painful defecation leading to symptoms such as infrequent and painful bowel movements, faecal incontinence, retentive posturing, and urinary complications. The data on functional constipation from developing nations like Nepal remain scarce. This study aims to find out sociodemographic and clinical characteristics of functional constipation among Nepalese children thereby facilitating early diagnosis and intervention strategies to mitigate its impact.

A descriptive cross-sectional study was carried out over a six-month period, from 1st July to 30th December, 2023, at a tertiary-level hospital with sample size of 241. Children aged 1-15 years meeting the Rome IV diagnostic criteria for functional constipation were included in the study. Demographic information along with clinical history was collected and analysed using STATA13.

Hard stools or painful bowel movements were reported in 197 (81.74%) children, stool-withholding behavior in 98 (40.66%), and fecal incontinence in 37 (16.18%). Other associated symptoms included abdominal pain in 161 (66.79%), decreased appetite in 95 (39.00%), and gastroesophageal reflux in 83 (34.44%) cases. Rectal bleeding was observed in 51 (21.16%) and urinary incontinence in 26 (10.91%) children. A family history of constipation was noted in 71 (29.46%) cases.

Functional constipation is a prevalent paediatric gastrointestinal disorder, significantly impacting a child’s quality of life. Early recognition and intervention are crucial to prevent complications and enhance outcomes.