The effects of lifestyle changes like diet, toilet habits, physical activity and others in children with functional constipation

Background: Functional constipation is common in pediatric age group. Our aim is to evaluate the effects of lifestyle changes (diet, toilet habits, physical activity and others) in children with functional constipation, and to assess the risk factors of functional constipation in Indian children.Methods: This was an observational, prospective, questionnaire and proforma based (pretested and predesigned) follow-up study. Duration was from January 2016 to December 2017. Study was conducted at, department of paediatrics, Mahatma Gandhi Medical College, Jaipur.Results: On regular follow-up, stool frequency was improved after changing the lifestyle factors like adequate physical activity (p<0.05, CI: 0.27) and regular toilet habits (p<0.05, CI:0.93), blood/mucus, straining, painful defecation and pain abdomen, all are showing significant improvement (p<0.05) after relieving constipation. On regular follow-up Need of disimpaction (polyethylene glycol or proctoclys enema) reduced significantly (p=0.001), number of cases with adequate fiber diet improved significantly (p=0.001), Number of children consuming frequent junk food decreased significantly (p=0.001). Conclusions: Initial disimpaction, if needed and maintenance laxative therapy (1-3 months as per need) along with major lifestyle changes like fibers rich diet, avoidance of junk food, adequate physical activity, optimal sleep hygiene, and daily regular toilet habits have significantly positive correlation with improvement in functional constipation and its symptoms.

Gastroesophageal reflux disease in bronchial asthma and the response to omeprazole.

The objective of this study was to determine the incidence of gastroesophageal reflux disease (GERD) in bronchial asthma and the role of omeprazole for asthmatics with symptoms of GERD. Seventy asthmatics were screened for GERD by questionnaire. Patients with a history suggestive of GERD were confirmed by Bernstein test and further investigated for airway responsiveness to instillation of HCl in the esophagus. Symptom score, drug score and spirometric values were recorded initially and after four weeks of treatment with omeprazole. It was found that 74.28% of asthmatics had a history of GERD. Forty patients tested positive by Bernstein test and also showed airway responsiveness to instillation of HCl in the esophagus. There was a significant improvement in symptom scores (p < 0.001), drug scores (p < 0.001) and spirometric values (p < 0.001) after adding omeprazole to their treatment regimen. It was concluded that bronchial asthma and GERD are associated in the majority of patients (57.14%) and such patients are likely to improve with omeprazole.