The outcome of functional constipation in Saudi children.

Mohammad El Mouzan, Hayfa Alabdulkarim, Mohammed Kambal, Nawaf Alshammary, Rehab Alanazi, Shaffi Ahamed, Nouf Alhamid, Ahmed Al Sarkhy, Alhanouf Alzahrani, Asaad Assiri
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Abstract

Background: Understanding the outcome of functional constipation (FC) for both patients and physicians is essential, yet it has been infrequently reported worldwide. The objective of this report was to update the outcomes of FC in Saudi children.

Methods: Clinical data including age, sex, response to management, duration of follow up, and type of management were collected from the notes of each clinic visits and phone call follow-ups.

Results: The study included 268 children followed up for a 7 year duration. The median age of onset was 4 (0.1 to 13) years, and 123/268 (46%) were male. There was an increasing recovery rate with increasing duration of follow up with an overall recovery rate of 79%. There was no significant association between recovery and age at onset (p=0.0860) or duration of constipation (P=0.124). Management by pediatric gastroenterologists did not increase rate of recovery (81% vs. 77%, p=0.432) or being cured (47% vs. 36%, p=0.108) significantly. According to the parents of children who recovered, diet in association with polyethylene glycol (PEG) and toilet training were most helpful. Poor diet and nonadherence to medications were the most common causes of lack of recovery.

Conclusions: The higher rates of recovery in this Middle Eastern childhood population than other populations are possibly related to cultural characteristics. The parents' views support the importance of diet associated with other modalities as important parts of management.  Further research is needed to identify correctable causes of nonadherence to treatment to improve recovery.

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沙特儿童功能性便秘的结果。
背景:了解功能性便秘(FC)的结果对患者和医生都是至关重要的,但在世界范围内很少有报道。本报告的目的是更新沙特儿童FC的结果。方法:从每次就诊记录和电话随访中收集患者的年龄、性别、对治疗的反应、随访时间、治疗方式等临床资料。结果:该研究包括268名儿童,随访时间为7年。中位发病年龄为4岁(0.1 ~ 13岁),123/268例(46%)为男性。随着随访时间的延长,回收率逐渐增加,总回收率为79%。恢复与发病年龄(p=0.0860)或便秘持续时间(p= 0.124)无显著相关性。儿科胃肠科医师的治疗并没有显著提高康复率(81%对77%,p=0.432)或治愈率(47%对36%,p=0.108)。据康复儿童的父母称,与聚乙二醇(PEG)相关的饮食和如厕训练最有帮助。不良的饮食和不坚持药物治疗是缺乏恢复的最常见原因。结论:中东儿童群体中较高的康复率可能与文化特征有关。家长们的观点支持了饮食与其他方式作为管理的重要组成部分的重要性。需要进一步的研究来确定不坚持治疗的正确原因,以提高康复。
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