Evaluation of the Growth Parameters in Children with Chronic Functional Constipation

Abstract

Background: Chronic functional constipation is an epidemic problem in children that has effects on the growth status. Objectives: The aim of this study is to evaluate the growth parameters in children with chronic functional constipation and compare them with healthy individuals. Patients and Methods: One hundred children with chronic functional constipation (defined as Rome III criteria) referred to Pediatric Gastroenterology Clinic enrolled in this study. Control group was consisted of 100 children who referred for well-child visits, without constipation. Weight, height, body mass index (BMI) and Z-score weight, Z-score height and Z-score BMI was calculated for each patient and control group. Results: Both case and control groups were consisted of the same age (P = 0.725) and gender (P = 0.777) individuals. The BMI (P < 0.0001) and BMI Z-scores (P < 0.0001) of constipated children was significantly higher than the control group. Also, weight (P = 0.004) and weight Z-scores (P < 0.0001) were significantly higher in the study group. There was no significant difference in height between two groups (P = 0.1), but constipated children had higher height Z-scores than control group (P = 0.027). The rate of obesity (define as BMI Z-score > 2) in children with chronic constipation was 40% that was significantly higher than normal control group (11%) (P < 0.0001). Conclusion:We found a higher obesity rate and also higher BMI and weight Z-scores in functionally constipated children compared with healthy control group. The reasons for the association between obesity and constipation are not clear and multifactor including diet, activity level, or hormonal influences, are involved that required additional studies.

How Does Functional Constipation Affect Growth Status in Children?

“…In a study by Ilan et al most of the children with constipation were obese or overweight (21). In a similar study conducted on 100 Iranian children younger than 18 years old with functional constipation Dehghani et al found a higher obesity rate and higher BMI and weight Z scores in constipated patients compared to healthy control group (22). Pawlowska et al demonstrated that pediatric patients with functional gastrointestinal disorders present various growth abnormalities.…”

Intestinal Functional among Adolescents in Brazil

“…A higher prevalence was detected by other authors, such as a 22.3% rate among constipated adolescents enrolled in a high school in the city of dos Campos (Brazil) [14], 35% rate in a study conducted by Trisóglio et al [18] among students of a faculty of medicine in the interior of the state of São Paulo, and a 40% rate detected by Jamie et al among university students in the city of Goiânia (Brazil) [6]. In these studies there was a statistically significant predominance of teenage girls, as also observed by Zaslavsky et al in a study of 48 adolescents with intestinal constipation seen at the University Hospital of Porto Alegre [20] and by Dehghani et al [21] among adolescents attended at a gastroenterology service in Iran.…”

TTG IgA in Functional Constipation: Is It Rational to Be Evaluated?

“…Similarly, in the studies performed by Dehghani et al 4 , there was the systemic review of van den Berg et al, which demonstrated no considerable differences between the genders. 5 Striking disparity in the weight between two groups could have resulted either from the anorexia in the domain of FC that varies from 10% to 38% in these patients, or from silent undiagnosed CD.…”

“…[1][2][3] The most common initiator of FC in childhood is an experience of painful defecation. 4 The estimated prevalence of FC is between 0.3% to 8% of pediatric population that is different according to race and geographic regions. 2,4 The FC is diagnosed based on Rom III criteria and there is no need for laboratory workup except for precise history and physical examination, [1][2][3][4][5] though some authors suggest evaluation for celiac disease (CD) in constipated patients especially in severe and refractory cases before making the diagnosis of FC in such patients.…”

“…4 The estimated prevalence of FC is between 0.3% to 8% of pediatric population that is different according to race and geographic regions. 2,4 The FC is diagnosed based on Rom III criteria and there is no need for laboratory workup except for precise history and physical examination, [1][2][3][4][5] though some authors suggest evaluation for celiac disease (CD) in constipated patients especially in severe and refractory cases before making the diagnosis of FC in such patients. 5,6 CD is commonly manifested at any age with chronic diarrhea, loose stool, vomiting, abdominal distention, constipation, or symptoms of malabsorption syndrome; however, recently presenting CD as a malabsorption syndrome is not a rule.…”