A Clinical Study of Chronic Functional Constipation in Children Treated for more than Five Months

Kim, Young Min; Choi, Sung Yun; Bae, Sun Hwan; Ahn, Young Min

Abstract

PURPOSE
The purpose of this study was to evaluate the clinical features and the courses and effects of long-term treatment, and to analyze the association between clinical features and duration of therapy in chronic functional constipation in children.
METHODS
This study enrolled 57 children with chronic functional constipation who were treated in the Eulji Hospital for more than five months between May, 2000 and February, 2004. We analyzed the clinical features and the courses and results of the phase of disimpaction, maintenance, weaning retrospectively.
RESULTS
Mean age at diagnosis was 3.3+/-2.3 years and the male to female ratio was 24:33. The mean duration of symptoms was 12.5+/-13.9 months in 49 patients. Mean defecation frequency per week was 5.7+/-4.0 and hard stools were seen in 59.7% of patients. The clinical presentations were as follows : abdominal pain(45.6%), rectal blood loss(28.1%), vomiting(19.3%). Fifty-four patients had successful disimpaction with lactulose+bisacodyl/glycerine enema or only lactulose, except for three patients with polyethylene glycol(PEG) solution. After a maintenance phase with lactulose or lactulose+mineral oil, a significant increase in defecation frequency per week was observed(5.7+/-4.0 to 6.3+/-1.8(P<0.05)), discomfort in defecation was not observed in all patients and hard stools were not observed except in four patients. The mean duration of the maintenance phase was 5.5+/-4.3 months and mean duration of total therapy was 10.8+/-3.8 months in 42 patients who finished the weaning phase. Duration of the maintenance phase and of total therapy had no statistical correlation with age, duration of symptoms and frequency of stools, and had no association with clinical presentations.
CONCLUSION
Long-term treatment is necessary for effective treatment of chronic functional constipation in children. Further long-term follow up would have to be perfomed to evaluate successful treatment.