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Article Type

Original Study

Subject Area

Pediatrics

Abstract

Background: A chronic constipation is one of the most common functional gastrointestinal complaints in pediatric outpatient clinics. The prevalence of childhood constipation in the general population ranges widely from 0.7% to 29.6% internationally. Pediatric Gastroenterology Clinic at Elbeheira specialized children's Hospital is a referral center from the whole governorate. Objectives: To evaluate the current approach to management, risk factors associated, and clinical characteristics, the challenge of functional constipation in the pediatrics who are attending the Pediatric Gastroenterology Clinic at Elbeheira Specialized Children's Hospital. Methods: This retrospective study was conducted in Pediatric Gastroenterology Clinic at Elbeheira Children's Specialized Hospital for 6 months (from October 2022 to April 2023). All children from 1 month to 15 years of age came to the pediatric GIT clinic complaining of functional Constipation as defined in Rome IV criteria were included. Children with evidence of organic cause of constipation were excluded. Google form sheet developed by the researcher to collect the demographic data. Detailed history and examination were performed. Laboratory investigations were when indicated to confirm fecal impaction and to exclude any underlying organic cause. The plan of management included pharmacological treatment (Laxatives), Toilet desensitization, rewards, and counseling). Results: in our study, 46.7% of the patients were in the school-age, 48% were females, two-thirds lived in rural areas, and 70% of their caregivers were educated. The median age at the onset of constipation in most of them was 12 months Twenty-nine children (19.3%) suffered from associated diseases. The median duration of pre-referral treatment was 10.5 months, mainly including osmotic laxatives (27.3%) and oral stimulants (11.3%). The main triggering factors for functional constipation (FC) were toilet training (39.3%), urge postponing at school (32%), and weaning practices (24.7%). The main complaints were abdominal pain (60%), delayed passage of stool (53.3%), and hard stool (38%). Physical findings before treatment revealed abdominal distention (76%), palpable fecal mass (46%), rectal mass (8.7%), and anal fissure (5.3%). After treatment, the majority of caregivers (96%) were significantly educated on non-pharmacological management. The majority of children received osmotic laxatives (98.7%), stimulants (89.3%), and softeners (74%). The main challenges were compliance with treatment (51.3%), unclear medical history (16.7%), withholding behavior (14.7%), and previous investigations (8%). Positive response to treatment was reported in 141 children (94%) which was not affected by either sociodemographic characteristics, presence of associated diseases, age at onset of constipation, anthropometric measurements, or relevant and pre-referral history (P>0.05). The mean duration of fecal dis-impaction was 5.28 ± 2.06 days, and the regular bowel movement was restored after a mean duration of 32.4 ± 14.6 days. All After treatment, all symptoms and physical findings showed significant improvements (P

IRB Number

IRB0000687

Keywords

functional constipation, incontinence

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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