RISK FACTORS OF FUNCTIONAL CONSTIPATION AMONG THAI CHILDREN

Wannaporn Wanichsetakul and Anundorn Wongteerasut

Abstract

Functional constipation is a common problem in pre-school children precipitated by intrinsic and extrinsic conditions. Risk factors associated with functional constipation among pre-school Thai children were identified in a case-control study employing a questionnaire based on Rome IV criteria among children 1-4 years of age (constipated, n = 45, non-constipated, n = 45) attending an outpatient department between September 2017 and January 2018. A significant common risk factor was a family history of constipation (p-value = 0.012). Univariate logistic regression analysis revealed significant differences between constipated and non-constipated group in exclusive formula feeding during the first year of life (odds ratio (OR) = 9.51, 95% confidence interval (CI): 1.14-79.6), daily vegetable or fruit ingestion of less than 1 ladle (OR = 9.63; 95% CI: 3.67-25.25), less than 250 ml daily water intake (OR = 4.42, 95% CI: 1.69-11.58), daily fruit juice intake of <250 ml (OR = 2.58; 95% CI: 0.62-10.69), weekly energetic (sweating) movement/activity of ?4 days (OR = 8.11; 95% CI: 0.95-68.87), and major stressful event (OR = 9.51, 95% CI: 1.14-79.6). A multivariate logistic regression analysis indicated limited fruit or vegetable ingestion (adjusted OR = 11.07, 95% CI: 3.82-32.08) and water intake (adjusted OR = 5.47, 95% CI: 1.73-17.34) are significant independent risks for constipation in children. The study highlights recognition of these risk factors by parents or caregivers as well as physicians in order to modify feeding behavior and avoid pharmacological intervention of constipation in children in the country.