Prevalence of Chronic Constipation and Its Psychosocial Impact on Children Aged Between 4 to 14 Years and Their Parents : A Hospital Based Cross - Sectional Study

Abstract

BACKGROUND:Gastrointestinal functional disorders especially constipation cause morbidity in otherwise healthy children with an estimated prevalence of 1% to 30%. It is perceived as a benign, easily treatable condition however left untreated, can lead to complications (Faecal impaction, incontinence and bowel perforations). Only a small proportion of patients seek medical advice; thus, the exact prevalence of the disorder is difficult to estimate. AIMS: To estimate the prevalence of chronic functional constipation in children aged 4-14 years and the degree of psychosocial impact on children and their parents. SETTINGS AND DESIGN: This cross-sectional study was carried out at K.R and Cheluvamba Hospital, MMC &RI, MYSORE from 1st FEB 2014 to 31ST MAY, 2014. METHODS AND MATERIAL: Constipation was defined using Rome III criteria. Children with organic causes of chronic constipation were excluded. Abdominal pain, fecal mass, anorexia, fecal soiling, withholding behavior were recorded. Psychosocial impact on children and parents was assessed using Paediatric Quality Of Life Inventory (PQLI) and modified PIP Questionnaires. Scoring done according to instructions given with respective questionnaires. STATISTICAL ANALYSIS: Prevalence was calculated using rates, ratios and percentages. Tests of significance were performed wherever relevant. P value of less than 0.05 was considered significant. RESULTS:The prevalence of functional constipation was estimated to be 14.29% with higher prevalence in females as compared to males i.e. 16.19% vs. 13.42%. Perineal soiling was significantly associated with functional constipation i.e. 58.33%. Mean score of all children was 75.4 and 70.6 for physical and psychosocial impact. 88% children reported PQLI score <80 (Mean 69.4). No difference between male and female child (p=.614). 83.33% parents reported score <80(Mean 69.3). No significant difference on psychosocial impact and quality of life according to PQLI parent report (p=1). CONCLUSIONS: High prevalence of functional constipation was observed amongst the younger female children. Children with chronic constipation have a lower quality of life. This study proves that functional constipation, its associated factors and complications are frustrating to the child and their parents.