The problem of defecation disorders in children is underestimated and easily goes unrecognized: A cross-sectional study

Marjolijn E. W. Timmerman*, Monika Trzpis, Paul M. A. Broens

*Corresponding author for this work

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    Abstract

    We aimed to study constipation and fecal incontinence in terms of prevalence, recognizing the disorders, help-seeking behavior, and associated symptoms. In this cross-sectional study, 240 children (8 to 18 years) from the general Dutch population completed a questionnaire about defecation disorders. After exclusions for anorectal/pelvic surgery or comorbidities, we analyzed 212 children. The prevalence of constipation was 15.6%; in a quarter of the cases, it co-occurred with fecal incontinence. We found 3% fecal incontinence without constipation. Even though children with a defecation disorder rated their bowel habits worse compared to children without defecation disorders (P < 0.001), 46% constipated children and 67% fecally incontinent children rated their bowel habits as good or very good. Moreover, 21 to 50% of children with a defecation disorder did not mention their symptoms to anybody. Interestingly, most constipated children had "normal" stool frequencies (64%) and consistencies (49%).

    Conclusion: The prevalence of constipation and fecal incontinence is quite high in children. Stool frequency and consistency is normal in half the constipated children, which may complicate the recognition of constipation. Finally, a considerable number of children does not recognize their disorders as constituting a problem and does not seek help, which leads to an underestimation of these disorders. What is Known: • Constipation and fecal incontinence are common in children, but their prevalence rates may be underestimated due to a variety of reasons. • Diagnosing these disorders remains challenging owing to the variety of symptoms and co-existence with other diseases. What is New: • The prevalence of constipation and fecal incontinence in children is high. • Many children do not recognize their defecation disorders as constituting a problem and do not seek help, which leads to an underestimation of the problem of these disorders.

    Original languageEnglish
    Pages (from-to)33-39
    Number of pages7
    JournalEuropean Journal of Pediatrics
    Volume178
    Issue number1
    DOIs
    Publication statusPublished - Jan-2019

    Keywords

    • Constipation
    • Fecal incontinence
    • Help-seeking behavior
    • Prevalence
    • Stool frequency
    • Stool consistency
    • FUNCTIONAL GASTROINTESTINAL DISORDERS
    • QUALITY-OF-LIFE
    • CHILDHOOD CONSTIPATION
    • FECAL INCONTINENCE
    • HEALTH-CARE
    • EPIDEMIOLOGY
    • ADOLESCENTS
    • PREVALENCE

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