Pediatr Gastroenterol Hepatol Nutr.  2020 Jan;23(1):26-34. 10.5223/pghn.2020.23.1.26.

Clinical Features of Severely Constipated Children: Comparison of Infrequent Bowel Movement and Fecal Soiling Groups

Affiliations
  • 1Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea. baedori@hanafos.com

Abstract

PURPOSE
To compare the clinical features, diagnostic findings, and medications of children with infrequent bowel movements or fecal soiling.
METHODS
This study enrolled 333 children (189 male; age range, 1 month to 18 years) diagnosed with functional constipation by Rome III or IV criteria. We classified them into 3 groups (infrequent bowel movement without fecal soiling [G3-a], infrequent bowel movement with fecal soiling [G3-b], and fecal soiling only [G3-c]) and into 2 subgroups of fecal soiling (G2-b) or not (G2-a). Retrospective data on clinical characteristics, colon transit time (CTT) test results, and medications were collected. The Wilcoxon rank-sum test, Kruskal-Wallis test, Chi-square test, and Fisher's exact test were used for the statistical analysis.
RESULTS
The median age (months) and interquartile range (IQR) was 33 (45) in G3-a, 54 (40) in G3-b, and 73 (48) in G3-c (p < 0.0001). G3-c had the latest onset (median, 18; IQR, 18; p=0.0219) and longest symptom duration (24 [24], p=0.0148). PEG 4000 was used in 60.6% (G3-a), 96.8% (G3-b), and 83.2% (G3-c) of patients (p < 0.0001). The median age (months) and IQR were 33.0 (45.0) in G2-a and 63.5 (52.5) in G2-b (p < 0.0001). G2-b had later onset (median, 12; IQR, 19.5; p=0.0062) and longer symptom duration than G2-a (24 [12], p=0.0070). PEG 4000 was used in 60.6% (G2-a) and 88.3% (G2-b) of children (p < 0.0001). No statistically significant intergroup differences were seen in maintenance laxative dose, CTT, or CTT type.
CONCLUSION
Infrequent bowel movement and fecal soiling represent the advanced stage of chronic functional constipation.

Keyword

Constipation; Child; Fecal incontinence; Defecation; Oroanal transit; Polyethylene glycol

MeSH Terms

Child*
Colon
Constipation
Defecation
Fecal Incontinence
Humans
Male
Polyethylene Glycols
Retrospective Studies
Soil*
Polyethylene Glycols
Soil
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