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The impact of constipation on growth in children.
Pediatr Res. 2008 Sep; 64(3):308-11
Carlo Di Lorenzo, Pediatric Academic Association, Ohio, USA. F1000 Gastroenterology & Hepatology
28 Jan 2009 | New Finding, Clinical Trial
This is the first study that shows a systemic effect of a condition traditionally considered very benign: childhood functional constipation.
It has been reported by other investigators that constipated children are more likely to have dyspeptic symptoms that improve with treatment of constipation {1}. In this study, the authors follow up on that notion by demonstrating that children with constipation are smaller than control children, and they convincingly show that treatment of constipation improves weight, height and BMI. Such improvement in growth parameters correlates with an increase in appetite. They were able to enrol and follow up an extremely large cohort of patients. This is an interesting finding with potentially important implications. Pediatricians may wish to inquire about constipation in children presenting with suboptimal weight gain and be aggressive in the treatment of this condition when poor appetite is a concern.
References: {1} Boccia et al. Clin Gastroenterol Hepatol 2008, 6:556-60 [PMID:18378497].
Competing interests: No potential interests relevant to this article were reported.
Di Lorenzo C: "This is the first study that shows a systemic effect of a condition traditionally considered..." Evaluation of: [Chao HC et al. The impact of constipation on growth in children. Pediatr Res. 2008 Sep; 64(3):308-11; doi: 10.1203/PDR.0b013e31817995aa]. Faculty of 1000, 28 Jan 2009. F1000.com/1145181#eval602329
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Di Lorenzo C: 2009. F1000.com/1145181#eval602329
Faculty of 1000 evaluations, dissents and comments for [Chao HC et al. The impact of constipation on growth in children. Pediatr Res. 2008 Sep; 64(3):308-11; doi: 10.1203/PDR.0b013e31817995aa]. Faculty of 1000, 28 Jan 2009. F1000.com/1145181
Short form
Faculty of 1000: 2009. F1000.com/1145181
The observation on the impact of constipation on nutritional and growth status in healthy children was never reported. During a 4-y period, we evaluated the consequence of constipation on growth in children. The enrolled children were aged between 1 and 15 y with constipation. Medical response of constipation to treatment was evaluated by the scoring of constipation symptoms. The correlation of therapeutic effect of constipation with growth status at 12 wk and 24 wk was statistically evaluated. About 2426 children (1284 boys, 1142 girls) with a mean age of 7.31 +/- 3.65 (range 1.1-14.9) y were enrolled. After 12-wk treatment, significant increase of z-scores of height-for-age, weight-for-age, and body mass index-for-age were all found in patients with good medical responses (1377 cases) than in those with poor medical responses (1049 cases). The 1049 patients with poor medical response received advanced medications; significant increase of z-scores of height-for-age, weight-for-age, and body mass index were also found in these patients. A marked increase of appetite was significantly correlated with better gain on height and weight after treatment. We conclude that chronic constipation may retard growth status in children, and a long-term medication for constipation in children appears beneficial to their growth status.
DOI: 10.1203/PDR.0b013e31817995aa
PMID: 18414138
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