30Apr 2018

PREVALENCE, CHARACTERIZATION AND RISK FACTORS OF CHRONIC CONSTIPATION AMONG SAUDI CHILDREN: A CROSS-SECTIONAL STUDY.

  • Departments of Pediatric Gastroenterology.
  • Pediatric , Departments of Pediatric Gastroenterology.
  • Neonatology , Departments of Pediatric Gastroenterology.
  • Endocrine , Departments of Pediatric Gastroenterology.
  • King Saud Bin Abdulaziz University for Health Sciences, National Guard Hospital, Jeddah, Saudi Arabia, Department of Pediatric Gastroenterology , College of Medicine and King Khaled University Hospital. King Saud University, Riyadh, Saudi Arabia.
Crossref Cited-by Linking logo
  • Abstract
  • References
  • Cite This Article as
  • Corresponding Author

Background: Childhood constipation is a common gastrointestinal disorder worldwide and many factors have been associated with the occurrence of constipation. Objectives: The aim of this study was to determine the prevalence and risk factors for chronic constipation among school-age children in Saudi Arabia. Methods: A cross-sectional study was conducted between February 2016 to May 2016 May. We selected the two largest cities: Jeddah and Makah in the Western region of Saudi Arabia. Children aged 7-17 years were recruited from 15 schools, using a random sampling technique in which all students have an equal and independent chance of being selected. A validated self-administered questionnaire on Rome III criteria for diagnosing chronic constipation and its predisposing factors was filled by each participant in a classroom setting. Results: Of the 9100 questionnaires distributed to school children, 7644 (response rate 84%) were completed and analyzed. Chronic constipation was present in 2459 (32.2%) with significant differences in constipation between girls and boys (77.6% vs 22.3%; p <0.001). The significant risk factors for chronic constipation included family history of constipation (OR=2.69, 95% CI = (2.33-3.09) and psychological/behavioral problems (OR=3.02, 95% CI (2.42-3.76). School toilet phobia, night sleeping <7 hours, homework >3 hours/day, omitting breakfast and exercise in school did not predispose the students to develop chronic constipation (all p < 0.001). The following variables were found to be significantly associated with chronic constipation; straining during defecation (OR = 30.15, 95% CI = (24.88-36.53), painful defecation (OR=18.41, 95% CI = (15.89-21.35), bloody stool (OR = 3.97, 95% CI = (3.16-4.99), and fecal incontinence (OR = 7.84, 95% CI = (6.49-9.47). Conclusion: Chronic constipation is a significant health problem among Saudi children. Exposure to stressful life events at school did not predispose the participants to develop constipation. Chronic constipation prevalence of 32.2% in study population warrants preventive measures such as health education and preventing childhood psychological insults.

  1. Loening-Baucke V. Chronic constipation in children. Gastroenterology 1993;105:1557?64.
  2. Mugie SM, Benninga MA, Di Lorenzo C. Epidemiology of constipation in children and adults: A systematic review. Best Practice & Research Clinical Gastroenterology 2011; 25(1): 3-18.
  3. Tam YH, Li AM, So HK, et al. Socio-environmental factors associated with constipation in Hong Kong children and Rome III criteria. J Pediatr Gastroenterol Nutr 2012; 55(1): 56-61.
  4. Lundblad B, Hellstrom AL. Perceptions of school toilets as a cause for irregular toilet habits among schoolchildren aged 6 to 16 years. J Sch Health 2005; 75(4): 125-8
  5. Rajindrajith S1, Devanarayana NM, Adhikari C, Pannala W, Benninga MA. Constipation in children: an epidemiological study in Sri Lanka using Rome III criteria. Arch Dis Child 2012;97(1):43-5
  6. Hasosah M, Telmesani A, Al-Binali A et al.Knowledge and practice styles of pediatricians in Saudi Arabia regarding childhood constipation.. J Pediatr Gastroenterol Nutr. 2013;57(1):85-92.
  7. Rasquin A, Di Lorenzo C, Forbes D, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2006; 130:1527?37.
  8. Ip KSLW, Chan JS, Young BW. A community-based study of the prevalence of constipation in young children and the role of dietary fibre. Hong Kong Med J. 2005;11(6):431?62
  9. Wald ER, Di Lorenzo C, Cipriani L, et al. Bowel habits and toilet training in a diverse population of children. J Pediatr Gastroenterol Nutr 2009;48:294?8.
  10. Chung JM, Lee SD, Kang DI, et al. An epidemiologic study of voiding and bowel habits in Korean children: a nationwide multicenter study. Urology 2010;76:215?9.
  11. Uc A, Hyman PE, Walker LS. Functional gastrointestinal disorders in African American children in primary care. J Pediatr Gastroenterol Nutr 2006;42:270?4.
  12. Turco R, Miele E, Russo M, et al. Early-life factors associated with pediatric functional constipation. J Pediatr Gastroenterol Nutr. 2014;58:307?312.
  13. Osatakul S, Puetpaiboon A. Use of Rome II versus Rome III criteria for diagnosis of functional constipation in young children. Pediatr Int. 2014;56:83?88
  14. Devanarayana NM, Rajindrajith S. Association between constipation and stressful life events in a cohort of Sri Lankan children and adolescents. J Trop Pediatr 2010;56:144?8.
  15. Zhou H, Yao M, Cheng GY, et al. Prevalence and associated factors of functional gastrointestinal disorders and bowel habits in Chinese adolescents: a school-based study. J Pediatr Gastroenterol Nutr 2011; 53:168?73.

[Mohammed Hasosah, Ashraf Alsahafi, Arwa Alghraibi, Nawal Alqarni, Areej Babatin, Ahmed Matrafi, Atif Alamri, Mansour Qurashi, Najia Atiah, Ahmad Al Sarkhy (2018); PREVALENCE, CHARACTERIZATION AND RISK FACTORS OF CHRONIC CONSTIPATION AMONG SAUDI CHILDREN: A CROSS-SECTIONAL STUDY. Int. J. of Adv. Res. 6 (Apr). 1319-1324] (ISSN 2320-5407). www.journalijar.com

Mohammed Hasosah
Department of Pediatric Gastroenterology, Assistant Professor of Pediatric, King Saud Bin Abdulaziz University for Health Sciences/Pediatric Consultant Gastroenterologist, King Abdul-Aziz Medical City, National Guard Hospital, Jeddah

DOI:

Article DOI: 10.21474/IJAR01/6986      
DOI URL: http://dx.doi.org/10.21474/IJAR01/6986

Download Full Paper

Download PDF No. of Downloads: 171 | No. of Views: 492