Abstract

Aim: To evaluate the predisposing factors and the two different treatment modalities in childhood chronic functional constipation. Methods: 276 patients between 2-18 years of age admitted in our Pediatric Gastroenterology and Nutrition Unit between January 2001-June 2003 and diagnosed as chronic functional constipation were enrolled in the study. The study group included patients with abdominal pain, painful defecation, blood in the stool, encopresis and constipation at least 3 month's duration. Patients with neurologic diseases and organic etiology were excluded. Therapoetic modalities in the treatment of functional constipation included toilet training (1-2 times/day- 10-15 min), fiber diet, lactulose (2-3 cc/kg), and lactitol (0.4-0.6 cc/kg). Patients were followed up in the 1st, 3rd, 6th, 9th, 12th months in the first year and every 6 months later. Results: The mean age of the patients was 6.69 ± 3.63 years, mean duration time was 3.44 ± 2.71 years. Freguency of the presenting complaints were found as 65.2% abdominal pain, 34.4% painful defecation, 15.5% encopresis, and 6.8% enuresis. While 8.6% of the constipated patients had phychosocial problems within their families, patients with encopresis had higher phychosocial problems (23%). At the end of the first month and the first year of teatment remission was found 38.5% and 75%, respectively. 36.7% of the lactulose group and 42.8% of the lactitol group had clinical improvement. Conclusioti: Psychosocial problems within the family has an important role on childhood functional constipation. Families should be trained on the etiology, treatment, prognosis of this problem and on proper psychosocial behavior. Medical treatment should be addressed when needed for better results.