Clinical Outcome and Long Term Follow-up of Chronic Functional Constipation in Children / 대한소아소화기영양학회지

ABSTRACT

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.