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KMID : 0816120060090020200
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Korean Journal of Pediatric Gastroenterolology and Nutrition
2006 Volume.9 No. 2 p.200 ~ p.209
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Clinical Outcome and Long Term Follow-up of Chronic Functional Constipation in Children
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Ahn Yoon-Jin
Park Jae-Ock
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Abstract
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Purpose: The purpose of this study was to evaluate the long term outcome and the factors contributing to treatment outcome for chronic functional constipation in children.
Methods: Sixty three children were enrolled who had chronic functional constipation and could be followed by telephone contact. They were treated at the Bucheon Soonchunhyang Hospital for more than 1 month and observed from March 2001 to June 2005. We analyzed the clinical features, symptoms and signs, as well as the course and results of treatment.
Results: The male to female ratio was 35 (55.6%)：28 (44.4%). The mean age at the onset of symptoms and diagnosis was 21.1±23.5 (1.9～84.0) months and 47.1±34.2 (6.9～138.0) months, respectively. The mean defecation frequency before treatment was 3.2±2.3 (0.5～10.0) times per week. The symptoms associated with constipation were as follows: soiling 34 (54.0%) which was more common in males than females, large stools in 30 (47.6%), decreased bowel movements less than three times a week in 20 (31.7%), straining during defecation in 19 (30.2%) and retentive posturing 19 (30.2%). The mean duration of follow-up was 34.2±14.6 (3.6～60.0) months and 44 (69.8%) patients had their symptoms resolve (“success”) and 19 (30.2%) were not resloved (“fail”) from the constipation. The time for recovery from soiling, straining during defecation and retentive posturing after treatment was 4.3±2.4 (1.0～36.0), 5.0±1.4 (0.8～36.0) and 5.0±3.1 (1.0～36.0) months, respectively. A relapse of the constipation occurred in 15 (23.8%) patients, 9 (60%) boys and 6 (40%) girls. The time to relapse after cessation of treatment was 2.9±1.9 (1.0～6.0) months and the only risk factor associated with relapse was the initial duration of treatment.
Conclusion: Most of the patients had resolution of symptoms within five months after treatment; relapse occurred within three months after the interruption of treatment. The duration of treatment was important for recovery and for the prevention of relapse in the constipated children. Thus a long term maintenance of therapy and follow-up is necessary for chronic functional constipation in children. (Korean J Pediatr Gastroenterol Nutr 2006; 9: 200～209)
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KEYWORD
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Chronic functional constipation, Outcome, Long term follow-up
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