Risk factors for formation of acute and chronic constipation in children and specificities of its course
The objective. To study risk factors, specificities of medical history, clinical manifestations and results of using laboratory-instrumental examination methods in children with acute and chronic constipation. Patients and methods. We examined 205 children with constipation syndrome, of them 66 children - with acute constipation (AC) and 139 children with chronic constipation (CC). The children's age averaged 10.1 ± 3.15 years. A comparative analysis of medical histories, specificities of the course of disease and findings of laboratory-instrumental examinations in children with acute and chronic constipation was performed. Results. Acute constipation was significantly more often diagnosed in 4-to-6-year-old children (p < 0.01) as compared with children with CC (23 of 66, as compared with 5 of 139, respectively, p < 0.01), whereas CC was more often diagnosed in children older than 6 years (43 of 66, as compared with 134 of 139, respectively, p < 0.01). Significantly more frequent risk factors for development of CC than for development of AC were as follows: bad obstetric history (in 38.8 and 18.2% children, respectively, p < 0.01), duration of feeding less than 6 months (20.9 and 72%, respectively, p < 0.01), inobservance of rational food regimen (51.8 and 32.4%, respectively, p < 0.01), associated pathology of the digestive organs (70.5 and 34.8%, respectively, p < 0.01) and unfavourable psycho-emotional climate in the family (48 and 22%, respectively, p < 0.01). Intervals between defecation lasting for 5 and more days (44.6 and 12.1%, respectively, p < 0.01), as well as faecal intoxication (51.7 and 0%, respectively, p < 0.01) and encopresis (54.7 and 10.6%, respectively, p < 0.01) were more often noted in CC as compared with children suffering AC. Conclusion. In-depth collection of medical history data and, if required, use of additional methods of examination are advisable in all children with constipation syndrome for early and targeted medical and, if necessary, psychological help to prevent the chronic course of disease.