Long-Term Prognosis for Childhood Constipation: Clinical Outcomes in Adulthood: clinical outcomes in adulthood

Marloes E. J. Bongers, Michiel P. van Wijk, Johannes B. Reitsma, Marc A. Benninga

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OBJECTIVES: This study examines long-term prognoses for children with constipation in adulthood and identifies prognostic factors associated with clinical outcomes. METHODS: In a Dutch tertiary hospital, children (5-18 years of age) who were diagnosed as having functional constipation were eligible for inclusion. After a 6-week treatment protocol, prospective follow-up evaluations were conducted at 6 and 12 months and annually thereafter. Good clinical outcomes were defined as >= 3 bowel movements per week for >= 4 weeks, with <= 2 fecal incontinence episodes per month, irrespective of laxative use. RESULTS: A total of 401 children (260 boys; median age: 8 years [interquartile range: 6-9 years]) were included, with a median follow-up period of 11 years (interquartile range: 9-13 years). The dropout rate during follow-up was 15%. Good clinical outcomes were achieved by 80% of patients at 16 years of age. Thereafter, this proportion remained constant at 75%. Poor clinical outcomes at adult age were associated with: older age at onset (odds ratio [OR]: 1.15 [95% confidence interval [CI]: 1.02-1.30]; P = .04), longer delay between onset and first visit to our outpatient clinic (OR: 1.24 [95% CI: 1.10-1.40]; P = .001), and lower defecation frequency at study entry (OR: 0.92 [95% CI: 0.84-1.00]; P = .03). CONCLUSIONS: One-fourth of children with functional constipation continued to experience symptoms at adult age. Certain risk factors for poor clinical outcomes in adulthood were identified. Referral to a specialized clinic should be considered at an early stage for children who are unresponsive to first-line treatment. Pediatrics 2010; 126: e156-e162
Original languageEnglish
Pages (from-to)E156-E162
Issue number1
Publication statusPublished - Jul 2010


  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Child, Preschool
  • Cohort Studies
  • Combined Modality Therapy
  • Confidence Intervals
  • Constipation/diagnosis
  • Diet
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laxatives/therapeutic use
  • Male
  • Probability
  • Prognosis
  • Recurrence
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Time Factors
  • Treatment Outcome

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