Shiraz E-Med J. 2018 February; 19(2):e13669.
Published online 2018 January 10.
doi: 10.5812/semj.13669.
Research Article
Investigation of Demographic and Clinical Characteristics of
Children with Constipation Referring to the Pediatric
Gastrointestinal Clinic, Shiraz in 2014 - 2016
Mahmood Haghighat,
1
Zahra Amiri,
2
Seyed Mohsen Dehghani,
1
Ali Reza Safarpour,
1
Maryam
Ataollahi,
1
Arash Mani,
1
Rahele Haghighat,
1
and Abbas Rezaianzadeh
3,*
1
Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
2
Shiraz University of Medical Sciences, Shiraz, IR Iran
3
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
*
Corresponding author: Abbas Rezaianzadeh, Shiraz University of Medical Sciences, Zand Street, Shiraz, 7134814336, IR Iran. Tel: +98-71-37251001; +98-9173150834, Fax:
+98-7137251009, E-mail: rezaiana@sums.ac.ir
Received 2017 May 18; Revised 2017 October 14; Accepted 2017 November 08.
Abstract
Background: Constipation is one of the most common Gastrointestinal (GI) symptoms among children. The present study aimed
to identify the demographic and clinical characteristics of the children suffering from constipation.
Methods: This descriptive-analytical study was conducted on 987 children with constipation in Fars province from March 2015 to
March 2016. The study data were collected in the pediatric GI clinic affiliated to Shiraz University of Medical Sciences and analyzed
using descriptive statistics, including frequency, mean, and standard deviation (SD).
Results: More than 40% of the cases who referred to the pediatric GI clinic were suffering from constipation. Totally, 987 [495 females
(50.2%) and 492 males (49.8%)] out of the 1000 children with constipation met the inclusion criteria. The remaining 13 children were
excluded due to non-functional constipation. The mean age of the children was 4.8 ± 2.8 years (range: 6.9 months to 17.7 years). In
addition, the children’s mean age at the beginning of toilet training and defecation control was 1.9 ± 0.5 years (range: 11 months to
5 years) and 2.1 ± 0.6 years (range: 17 months to 8 years), respectively. The mean of daily physical activity was 2.3 ± 3.6 hours and 707
children (71.6%) had less than one hour of daily physical activity. In addition, 54.2% and 13.9% of the children watched TV and used
computer games for more than 3 hours a day, respectively. Finally, 57.5% and 48.3% of the children reported a low consumption of
vegetables and grains per week, respectively. Furthermore, having constipation for more than six months was associated with the
age of onset of constipation less than two years (P = 0.003). Watching television was reported in 600 (69.7%) children with more
than six months constipation (P < 0.001).
Conclusions: More than 40% of the cases who referred to the pediatric GI clinic were suffering from constipation. Furthermore,
having constipation for more than six months was associated with the age of onset of constipation and watching television habits.
Keywords: Children, Constipation, Toilet Training, Vegetables
1. Background
Constipation is among the most prevalent gastroin-
testinal (GI) symptoms in children that, if untreated, can
lead to lots of complications (1). Constipation comprises
3% - 5% of inpatient referrals to pediatric physicians and
specialists as well as 25% of cases referring to pediatric gas-
troenterology clinics (2). This disorder does not usually
have any structural, endocrine, or metabolic causes and
is therefore identified as idiopathic or functional consti-
pation (3). Some studies have indicated that 90% - 95% of
cases suffer from functional constipation and only 5% - 10%
of children have organic factors (4). It is also a major prob-
lem for patients and their families and imposes a great bur-
den on the society (5). According to some studies, 16% of
parents reported constipation in their 22-month-old chil-
dren (6). The multifactorial pathophysiology of constipa-
tion has been accepted by researchers. Accordingly, con-
stipation occurred due to various factors, including low
consumption of fiber, positive family history, and socioe-
conomic status (7). Clinical evidence has suggested a re-
lationship between reduction of physical activity and the
increase of constipation among children. Several mecha-
nisms have been mentioned for justification of the prob-
able relationship between physical activity and gastroin-
testinal function among adults. Accordingly, it is believed
that physical activity increases intestinal drainage by in-
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