| Objective:The etiology of functional constipation(FC)has not been fully elucidated.Therefore,an epidemiological investigation was conducted to understand the incidence and main characteristics of FC in children,in order to analyze the etiology and main risk factors of FC in children,and to provide scientific theoretical basis for early prevention,early diagnosis and timely treatment.Method:From June 1,2016 to May 31,2021,125 children(4-10 years old)who were diagnosed with functional constipation according to the Rome IV diagnostic criteria in the pediatric outpatient clinic of our hospital and followed up were selected as the FC group.During the same period,125 healthy children who entered the kindergarten/enrollment in the outpatient clinic of the Children’s Health Department of our hospital and matched the age of the children in the FC group were selected as the control group.A face-to-face questionnaire was used to collect clinical data,including:1.General information:1)The child’s gender,age,ethnicity,household registration,birth weight,and history of birth diseases;2)The child’s parents’age,occupation,educational level,childbirth history,smoking history,and drinking history;2.Family environment:1)Family structure,living area,monthly income,parental history of constipation,whether there are caregivers and changes in the place of residence;2)Daily exercise,TV watching time,feeding method,supplementary food addition time,and eating speed,Picky eaters,partial eclipse,breakfast,snacks,daily water intake;3.Behavioural habits:the child’s stool characteristics,symptoms during defecation,reasons for not defecation,time to start defecation,whether there is feces left,holding and defecation training,and choosing the way to relieve defecation.All the collected clinical data were strictly checked,entered into and established a corresponding database,and analyzed using statistical software.Result:1.A total of 269 questionnaires were distributed in this survey(case group:139,control group:130),of which 250 were valid,with an effective rate of 93%;There were 111 male children(44.4%)and 139 female children(55.6%),with a male to female ratio of 0.79:1.The detection rate of FC in female children(76%)was significantly higher than that in males(27.02%),and the difference was statistically significant.(χ~2=42.145,P<0.001).2.The children in the constipation group were mainly aged 4 and 6 years old;the children in the control group were mainly aged 5 and 6 years old,and there was no significant difference in the detection rate of FC at each age.(χ~2=3.362,P>0.05).3.There were 127 Mongolian children(50.8%),119 Han children(47.6%),and 4 other ethnic minorities(1.6%).The detection rate of FC in Mongolian children(62.20%)was significantly higher than that in Han children(35.29%),and the difference was statistically significant(χ~2=23.637,P<0.001).4.There were 135(54%)children with urban household registration and 115(46%)children with rural household registration.The detection rate of FC among children with urban household registration(60.74%)was significantly higher than that of children with rural household registration(37.39%),and the difference between the two groups was statistically significant.(χ~2=13.543,P<0.001).5.From 2016 to 2021,the detection rate of FC in children has increased significantly since2017.6.The monthly family income of the constipation group was mainly concentrated in more than10,000 yuan;the monthly family income of the control group was mainly concentrated in5,000-10,000 yuan.The detection rate of FC in children with high family income(58.77%)was significantly higher than that of children with low family income(25%).and the difference was statistically significant(χ~2=8.709,P<0.05).7.The ages of the parents of the two groups were in line with the normal distribution,and the difference was not statistically significant(P>0.05).Commercial service industry,professional and technical personnel,agriculture,animal husbandry and fishery,and production and transportation equipment accounted for more than 50%,and the difference was not statistically significant(P>0.05).8.The most common defecation symptoms in children with functional constipation were strained defecation(81.6%),painful defecation(60%),and lumpy or hard defecation(55.2%).Defecation times less than 3 times per week,abdominal pain,painful defecation,laborious defecation,feeling of incomplete defecation,lumpy or hard defecation,needing hand assistance and blood in the stool are common symptoms.Most children have at least 2symptoms.9.Multivariate logistic regression analysis showed that household registration,whether parents had a history of functional constipation,whether there was a picky eater and a partial eclipse,drinking water,whether there was defecation training,and whether there was a habit of holding back stools were the influencing factors of FC.Among them,parents with a history of constipation(OR=5.836,95%CI:2.130～12.012),a picky eater(OR=6.110,95%CI:2.964～11.141),and a habit of holding back stools(OR=6.290,95%CI:3.128～12.363)were risk factors for constipation.Rural household registration(OR=0.201,95%CI:0.109～0.524),drinking water(OR=0.300,95%CI:0.122～0.541),and defecation training(OR=0.235,95%CI:0.102～0.498)were protective factors for constipation.Conclusion:1.Epidemiological characteristics of functional constipation:Children with constipation are mainly distributed in the age range of 4 to 6 years old,and the detection rate of FC in children has increased significantly since 2017.The detection rate of females is higher than that of males,the detection rate of Mongolian is higher than that of Han,the detection rate of urban household registration is higher than that of rural household registration,and the detection rate of households with high monthly income is higher than that of households with low monthly income.2.The most common symptom of functional constipation during defecation is laborious defecation;the most common reason for not defecation is fear of pain;the most common way for parents of children with constipation to relieve defecation is Carcero enema.3.The influencing factors for the occurrence of FC included household registration,whether parents had a history of constipation,whether there was a picky eater and a partial eclipse,drinking water,whether there was defecation training,and whether there was a habit of holding back stools.Among them,parents with a history of constipation,a picky eater,and a habit of holding back stools were risk factors for constipation.Rural household registration,drinking water,and defecation training were protective factors for constipation. |
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