Chronical Constipation: identification of the causes at a Bowel Management Clinic
DOI:
https://doi.org/10.51481/amc.v58i4.941Keywords:
constipation, Hirschsprung's desease, encopresis, colostomyAbstract
Background: Chronic constipation in the pediatric population is a common pathology that can affect the quality of life of the patient and the family. The initial experience at the Bowel Management Clinic is presented; patients with medical and surgical pathologies are included.
Methodology: the clinical files from the Bowel Management Clinic at the Hospital ""Dr. Maximiliano Peralta Jiménez"" were reviewed, including all the patients evaluated between June 2012 to June 2015. The patients considered as active, are those who are presently in control at the clinic and patients considered as solved those patients who were evaluated initially and then referred to the pediatric outpatient clinic or surgery.
Results: 77 patients were included, 25 were active patients (35%) and 52 solved (65%), that were referred from the pediatric and pediatric surgery outpatients clinic for difficult management constipation. In the active patients the diagnoses are: 16 patients (64%) functional constipation, 6 patients (24%) Hirschsprung's disease, 1 patient (4%) with Mowat Wilson's Syndrome, 1 patient with spina bifida and 1 patient with ptosis of the transverse colon. The motive for consultation of the active patients was a chronic constipation in 20 patients (80%), Hirschsprung's disease in 3 (12%) and encopresis in 2 patients (8%); the associated symptoms of this group of patients were: abdominal pain in 10 patients (40%), vomit in 3 patients (12%) and soiling in 19 patients (76%) From the 52 solved patients, 32 are men (61.5%) and 20 women. 44 patients (84.6%) have diagnosis of functional constipation, 6 (11.5%) Hirschsprung's disease, 1 patient (1.9%) imperforated anus with perineal fistula and 1 patient with anal stenosis. The motive for consultation was chronic constipation in 47 patients (90%), anal stenosis in 1 (1.9%), anorectal malformation in 1 (1.9%) and inflammatory pelvic disease also in 1 patient (1.9%).
Conclusions: The obtained results allow us to identify the most frequent causes of referral patients with chronic constipation to the Bowel Management Clinic at the Hospital ""Dr. Maximiliano Peralta Jiménez"". From all the patients referred for constipation of difficult management 15 (19 %) were detected for surgical resolution.
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References
Bischoff A, Levitt MA, Peña A. Bowel management for the treatment of pediatric fecal incontinence. Pediatr Surg Int. 2009, 25:1027-1042.
Levitt MA, Peña A. Pediatric Fecal Incontinence: A Surgeon´s Perspective. Pediatr Rev. 2010,31:91-100.
Jayasimhan S, Yap N, Roest Y, Rajandram R, Chin KF. Efficacy of microbial cell preparation in improving chronic constipation: A randomized, double-blind, placebo-controlled trial. Clin Nutr. 2013,30:1-7.
Aydogdu S, Cakir M, Yuksekkaya H, Arikan C,Tumgor G, Baran M, Yagci RV. Chronic constipation in Turkish children: clinical findings and applicability of classification criteria. Turk J of Pediatr. 2009, 51:146-153.
Keshtgar A, Ward H, Clayden G. Diagnosis and management of children with intratable constipation. Semin Pediatr Surg. 2004, 13:300-309.
Peña A, Levitt MA. Colonic inertia disorders in pediatrics. Curr Probl Surg. 2002,39:666-730.
Gillespie MC, Price KJ. The management of chronic constipation. Paediatr. Child Health. 2008,18:435-440.
Keshtgar A, Ward H, Clayden G. pathophysiology of chronic childhood constipation: Functional and morphological evaluation by anorectal manometry and endosonography and colonic transit study. J Pediatr Surg 2013, 48:806812.
Nurko S, Zimmerman LA. Evaluation and treatment of constipation in children and adolescents. Am Fam Phys. 2014, 90: 82-90.
Howarth LJ, Sullivan PB. Management of chronic constipation in children. Paediatr. Child Health. 2012,22:401-408.
Griffin SJ, Parkinson EJ, Malone PS. Bowel management for paediatric patients with faecal incontinence. J Pediatr Urol 2008,4:387-392
Diamanti A, Bracci F, Reale A, Crisogianni M, Pisani M, Castro M. incidence, clinical presentation, and management of constipation in a pediatric ED. Am J Emerg Med. 2010 ,28: 189-194
Hartman EE, Oort FJ, Sprangers M, Hanneman M, van Heurn LW, de Langen ZJ, et al. Factors affecting quality of life of children and adolescent with anorectal malformations or Hirschsprung disease. J Pediatr Gastroenterol Nutr.
, 47:1-9
Bove A, Bellini M, Battaglia E, Bocchini R, Gambaccini D, Bove V, et al. Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (Part II treatment) World J Gastroenterol. 2012 ,18: 4994-5013
Levitt MA, Martin CA, Falcone RA, Peña A. Transanal rectosigmoid resection for severe intractable idiopathic constipation. J Pediatr Surg 2009, 44:1285-
Levitt MA, Peña A. Surgery and constipation: When, How, Yes or No? J Pediatr
Gastroenterol Nutr. 2005,41:69-71
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