| Long-term prognosis for childhood constipation: clinical outcomes in adulthood. | |
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MedLine Citation:
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PMID: 20530072 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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 > or =3 bowel movements per week for > or =4 weeks, with < or =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. |
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Authors:
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Marloes E J Bongers; Michiel P van Wijk; Johannes B Reitsma; Marc A Benninga |
Publication Detail:
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Type: Journal Article Date: 2010-06-07 |
Journal Detail:
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Title: Pediatrics Volume: 126 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-02 Completed Date: 2010-07-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: e156-62 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam, Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age Factors Child Child, Preschool Cohort Studies Combined Modality Therapy Confidence Intervals Constipation / diagnosis*, therapy* Diet* Female Humans Kaplan-Meiers Estimate Laxatives / therapeutic use* Male Probability Prognosis Recurrence Risk Assessment Severity of Illness Index Sex Factors Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Laxatives |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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