Korean J Pediatr Gastroenterol Nutr.  2010 Mar;13(1):36-43. 10.5223/kjpgn.2010.13.1.36.

Factors Contributing to Treatment Outcome of Functional Constipation in Children

• Kim HS
• Hong YR
• We JH
• Park JH

• KMID: 1459442
• DOI: http://doi.org/10.5223/kjpgn.2010.13.1.36

Abstract

PURPOSE
The aim of this study was to evaluate the clinical features and factors contributing to treatment outcome for chronic functional constipation in children.
METHODS
We analyzed the medical records of patients with constipation, who visited the inpatient or outpatient clinic of the Department of Pediatrics of Pusan National University Hospital, between January 1998 and December 2007. The clinical features, outcomes, and factors affecting the treatment response according to the main drug (lactulose vs. PEG 4000) were analyzed retrospectively.
RESULTS
Two hundred forty children (142 males and 98 females) were enrolled in this study. The mean age was 51.2+/-37.9 months. The duration of symptoms was 32.6+/-33.7 months. The accompanying symptoms were as follows: encopresis, 91 (30.4%); abdominal pain, 76 (31.6%); and blood-tinged stool, 37 (15.4%). The treatment response was achieved earlier in females (p<0.001), patients with accompanying symptoms (p<0.05), and patients treated with PEG 4000 (p=0.001). The duration of symptoms (p<0.05) and stool frequency before treatment (p<0.05) were related to a delayed treatment response. Relapse occurred in 7 children, all of whom were treated successfully later.
CONCLUSION
Factors contributing to treatment response are female gender, accompanying symptoms, duration of symptoms, and stool frequency before treatment. PEG 4000 is superior to lactulose in response time and taken into consideration as a primary drug for the treatment of functional constipation of children. Early treatment and sufficient treatment time may also be important factors to achieve an early response and prevent relapse.

Keyword

Constipation; Functional; Children; Treatment

MeSH Terms

Abdominal Pain
Ambulatory Care Facilities
Child
Constipation
Encopresis
Female
Humans
Inpatients
Lactulose
Male
Medical Records
Pediatrics
Reaction Time
Recurrence
Treatment Outcome
Lactulose

Figure

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  Fig. 1 Age at symptom onset.

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  Fig. 2 Duration of symptoms before treatment.

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  Fig. 3 Stool frequency before treatment.

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  Fig. 4 Time interval between diagnosis and treatment response.

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  Fig. 5 Duration of treatment.

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