Socio-demographic characteristics and risk factors of functional constipation in children: A case-control study

Abstract

Background: Constipation is a worldwide problem among children. Functional constipation (FC) is the most common type of chronic constipation in children comprising 95% of them. Objectives: To study the socio-demographic characteristics and risk factors of FC in children. Method: This was a single centre, case-control study; 165 patients, ages ranging from early infancy to 17 years, who were suffering from FC were recruited for six months and they were age and sexmatched with 165 healthy controls. Using a questionnaire, data were gathered from those individuals and their caregivers regarding sociodemographic characteristics, dietary history, psychological insults, family history and socioeconomic status. All patients were examined abdominally and rectally. Results: Mean age of patients under study was 3.7 ± 3.3 years, and males were more affected than females. The male to female ratio was 2.3:1. The mean age at onset of the development of constipation among our cohort was 2.3 years. Male gender, prematurity, low birth weight, formula feeding during infancy, low fibre diet, positive family history of constipation, low socioeconomic status and illiteracy of the mother were all risk factors of FC and the association was highly significant. There was no association between type of residency or bodyweight with risk of FC. Fear of using the toilet was the most common underlying psychological insult. Hard stool was the most frequent presentation of our cohort followed by infrequent passage of stool. Faecal soiling, colic, anorexia, pain on defaecation, retentive posturing and nocturnal enuresis were also presenting symptoms. Urinary tract infection was seen in 34.5% of FC patients. Conclusions: Male gender, prematurity, low birth weight, formula feeding during infancy, low fibre diet, positive family history of constipation, low socioeconomic status and illiteracy of the mother were all risk factors of FC and the association was highly significant. Fear of using the toilet was the most common underlying psychological insult.