RESUMO
In a review of 538 children with functional constipation, we analyzed ages of presentation and onset, symptom duration, and behavioral/developmental problems. We divided the subjects into quartiles (Q1-Q4) based on age of onset. Median onset age was 2.3 years. The oldest group had the shortest symptom duration before referral at 1.8â±â1.8 years (compared with Q3 to Q1, Pâ=â0.039, Pâ=â0.001, Pâ<â0.001, respectively). Of the Q4 subjects, 22% had a behavioral/developmental problem (Pâ<â0.001 compared with Q1-Q3). We conclude that most children develop functional constipation as infants and toddlers, but those with later onset are more likely to have behavioral/developmental issues and see a specialist sooner.
Assuntos
Desenvolvimento Infantil , Constipação Intestinal/fisiopatologia , Sistema Digestório/fisiopatologia , Idade de Início , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Comorbidade , Constipação Intestinal/epidemiologia , Constipação Intestinal/terapia , Deficiências do Desenvolvimento/epidemiologia , Feminino , Hospitais Pediátricos , Humanos , Lactente , Masculino , Nova Orleans/epidemiologia , Ambulatório Hospitalar , Prevalência , Encaminhamento e Consulta , Estudos Retrospectivos , Fatores Sexuais , Fatores de TempoRESUMO
OBJECTIVES: The aim of the present study was to determine whether concomitant gastroparesis and biliary dyskinesia (BD) occur in children, and if so, to determine whether concomitant gastroparesis affects clinical outcome in children with BD. METHODS: We conducted a retrospective chart review of children with BD (ejection fraction <35% on cholescintigraphy, with no other metabolic or structural cause) who completed a solid-phase gastric emptying scintigraphy scan within 12 months of abnormal cholescintigraphy. Children were classified into 1 of 4 clinical outcome groups (excellent, good, fair, poor). RESULTS: Thirty-five children with a mean follow-up time of 23.1±17.3 (standard deviation) months were included. Twenty (57%) children were identified as having concomitant gastroparesis (GP) with BD. Children with concomitant GP were more likely to have a poor clinical outcome compared with those with BD alone (P<0.005). In children undergoing cholecystectomy, those with concomitant GP were more likely to have a fair or poor clinical outcome compared with those with BD alone (P<0.01). Factors predicting a more favorable clinical outcome were having BD alone and not having limitations in activity (eg, school absences) at the time of presentation. CONCLUSIONS: Concomitant GP may occur in children with functional gallbladder disorders. Concomitant GP may negatively affect clinical outcome in children with BD.