جستجوی مقالات مرتبط با کلیدواژه « functional constipation » در نشریات گروه « پزشکی »

 Changes in the intestinal microbial flora may contribute to the occurrence and intensification of functional constipation (FC). Probiotics have shown promise as a potential alternative treatment for constipation.

 The main goal of this study is to assess the effects of an Iranian multispecies synbiotic supplement on FC.

 This randomized controlled trial (RCT) recruited 115 adult patients who met the Rome IV criteria for FC after fulfilling the inclusion criteria. They were randomly assigned to receive either psyllium (n = 57) or psyllium plus synbiotic (n = 58) daily for 4 weeks. The treatment response was evaluated based on changes in stool consistency (based on the Bristol scale), bloating severity, and constipation intensity (based on the Wexner Constipation Scoring System), and those with a partial to excellent response were considered treatment successes.

 The two groups did not differ in terms of sex, age, and BMI. The downward trend of stool consistency, bloating, as well as, constipation intensity was significant after 2 weeks of synbiotic-containing intervention. Treatment success after 4 weeks was 75.44% in the synbiotic group, compared to 30.91% in the psyllium-alone group (P < 0.001), indicating the superior efficiency of the synbiotic. Neither treatment exhibited adverse effects (P = 0.924), although psyllium was found to be less tolerable than the synbiotic (P = 0.026).

 Multispecies synbiotic intake for 4 weeks may be a promising treatment option for FC, given its striking favorable effects on constipation severity, safety, and tolerability.

Chronic functional constipation is a common condition that declines the quality of life (QoL). The constipation-related disability scale (CRDS) precisely measures the disability caused by constipation and its effect on daily activities. In this study, we translated the CRDS into Persian and evaluated its reliability and validity. 

We used the international QoL assessment procedure to translate the CRDS into Persian. The translation was then given to 145 patients (59 men and 86 women) with chronic functional constipation. Also, 130 healthy individuals completed the questionnaire to assess its discriminant validity. The Cronbach α was calculated to assess the internal consistency, and the intra-class correlation coefficient showed the tool’s reproducibility. In addition, five gastroenterologists or internists reviewed the translated version to evaluate its acceptance and content validity. The content validity ratio and content value index were calculated in this regard. Finally, the Pearson correlation test assessed the tool’s convergent validity by correlating the CRDS with the 36-item short-form survey (SF-36).

The Cronbach α coefficient for total scores was found to be 0.86, indicating high internal consistency. The intra-class correlation coefficient was found to be 0.98 (95% CI, 0.96%, 0.99%), demonstrating excellent test re-test reliability. The total score of CRDS showed a strong negative correlation with the total scores of SF-36 (r=-0.89), showing its construct validity. All items of the Persian CRDS had a content validity index higher than 0.78 and a content validity ratio higher than 0.75, indicating good content validity. Furthermore, the independent t-test revealed a statistically significant difference (P < 0.05) between the healthy and diseased groups in questionnaire scores. This finding shows the tool’s ability to discriminate between healthy and sick groups. 

The Persian version of CRDS is suitable for evaluating constipation associated with disabilities in Persian-speaking individuals.

 Migraine and functional constipation are prevalent chronic conditions among children, with many children suffering from migraines also experiencing functional constipation.

 This study aims to investigate the impact of constipation treatment on headaches in children with migraines.

 This clinical trial involved 32 children aged 4 to 15 years, all diagnosed with both migraine and functional constipation. They were randomly divided into two groups: an intervention group and a control group, each comprising an equal number of participants. In the intervention group, both migraine and constipation were treated concurrently, whereas in the control group, only migraine was addressed. The outcomes of the two groups were then monitored and compared.

 After the treatment, the intervention group experienced a significant reduction in the average number of monthly headache attacks (3 ± 2.4) compared to the control group (7.1 ± 6.9) with a P-value of 0.016. The average duration of each headache attack was shorter in the intervention group (2.3 ± 4.8 hours) compared to the control group (2.9 ± 4.2 hours), although this difference was not statistically significant. Parental satisfaction with the treatment was higher in the intervention group than in the control group, but this difference also lacked statistical significance. Constipation treatment was successful in all children in the study.

 The study's findings indicate that treating constipation in children with both migraine and functional constipation significantly reduces the frequency of headache attacks. However, it does not have a significant impact on the duration of headache attacks or on parental satisfaction with the treatment.

Functional constipation (FC) is a common problem in childhood. It is estimated that 0.7 to30 percent of children suffer from CF all over the world. However, if the conservative treatments had no effects on constipation or symptoms are lasted for several years' surgery could be suggested. Unfortunately, there is no international standard definition of what failure of medical treatment actually means and to the surgeons and gastrointestinal (GI) physicians, this may not be the same in different centers.

This is a descriptive-analytical study which was done in Isfahan University of Medical Science, Isfahan, Iran, 2020. The aim was evaluation of outcomes of Duhamel operation in treating the children with megarectum suffering FC who admitted to Imam Hossein Hospital. Data were collected through a 3-part checklist. The first part was about demographic data such as age, gender, age of operation, and use of drugs before and after operation. Part 2 was Rintala-hall scoring system and part 3 was PICS for constipation.

In this study 40 children with FC suffering megarectum were studied and 38.1 percent (15) of children were boys. The mean± SD age of operation was 5.85± 2.92 years. The mean± SD score of incontinence were 10.85± 2.26 and 14.00± 2.38 before and after Duhamel, respectively. The mean score of constipation was 18.20± 3.00 before and 20.50± 2.39 after Duhamel. Paired t test showed that the mean score of incontinence and constipation were different significantly in 3, 6, 12 months after surgery (p< 0.05). So Duhamehh surgery can be concerned good method to treat megarectum due to FC.

Our findings indicated that Duhamel operation could help reliving the sign and symptoms of constipation and fecal incontinence in FC children.

Functional constipation (FC), or chronic idiopathic constipation, is one of the most common chronic disorders with no specific cause. Although FC is not associated with the progress of severe disease or additional mortality, it significantly decreases the patients’ quality of life. While several medications are available to treat constipation, there is no adequate treatment response in most cases. Herbal remedies are one of the most widely used options for FC.

In this double-blind controlled trial, all patients, researchers, and analysts were unaware of the ingredients contained in the drugs, as well as the assigned groups. We recruited a total of 90 elderly patients diagnosed with FC according to the Rome IV diagnostic criteria for irritable bowel syndrome (IBS). Patients were divided into two equal groups (n=45 in each) receiving fig-walnut syrup and lactulose syrup. Then, CBC-FBS-TSH-CR-NA-K-CA tests were taken from all patients, and the developed syrups (walnut-fig or lactulose) were prescribed to patients (15 cc half an hour before bedtime).

While 43 (95.6%) patients responded to treatment in the intervention group, 41 (91.1%) patients responded to treatment in the conventional treatment group. There was no statistically significant difference between the two groups in terms of response to treatment (P = 0.677).

The results showed that the oral syrups developed in this study improved FC in the elderly and had no side effects.

Fecal incontinence (FI) is a stressful condition for children and their parents that may affect the patient’s psychological well-being. Evaluating the patients’ psychological status may help physicians manage the disease effectively.

This study aimed to assess the emotional and behavioral disturbances in children with FI who were referred to the pediatric gastroenterology clinic in Mofid Children’s Hospital from April 2021 to 2022.

This cross-sectional study included children (over four years old) with chronic constipation and fecal incontinence. The diagnosis of chronic constipation and FI were made according to Rome-IV criteria. The Child Behavior Checklist (CBCL) evaluated patients’ emotional, behavioral, and social problems.

One hundred one patients with a mean age of 7.96 years were enrolled in the study; 67.32% were males. According to CBCL, 12% (12 patients) indicated emotional and behavioral problems, with CBCL scores in the clinical or at-risk range. We detected anxious/depressed problems in five (4.95%), withdrawn/depressed problems in eight (7.92%), somatic complaints in seven (6.93%), social problems in eight (7.92%), thought problems in nine (8.91%), attention problems in seven (6.93%), rule-breaking behavior in two (1.98%), and aggressive behavior in nine (8.91%) patients. The risk of internalizing and externalizing disorders was reported in four (3.96%) and five (4.95%) patients. Also, eight (7.92%) and seven (6.93%) patients had clinical symptoms of internalizing and externalizing disorders, respectively. There was no significant relationship between patients’ age and gender with the CBCL scores in any subscales. However, there was a significant difference in the total score among the age groups (P = 0.04).

The relatively high prevalence of emotional, behavioral, and social problems in our study corroborates the importance of psychological screening of children with FI during the treatment process.

Functional constipation as a common disorder in children, may be induce by psychiatric disorders. The present study aimed to evaluate and compared anxiety disorders in children with and without functional constipation.

This case-control study was conducted on 200 children (100 cases with functional constipation and 100 children without functional constipation) aged 15 - 8 years. The participants’ age and gender were evaluated and compared in two groups. Moreover, the Spence Children Anxiety Scale (SCAS) (parent form) for children was completed. Finally, the collected data were analyzed using SPSS software version 24.

Of 200 evaluated cases in the case and control groups, there were 46 (46.0%) and 59 (59.0%) males, respectively (P = 0.113). The mean ± SD of age in total, the case, and the control groups were 7.51 ± 1.91, 7.61 ± 0.91, and 7.41 ± 2.49 years, respectively (P = 0.585). Furthermore, SCAS in the case group was significantly higher (33.06 ± 14.4 vs. 24.8 ± 14.9, P = 0.001). Furthermore, the mean of separation anxiety disorder (P = 0.001), generalized anxiety (P = 0.003), and obsessive-compulsive disorder (OCD) were significantly higher in the functional constipation group (P = 0.001).

Anxiety was higher in children with functional constipation than in children without functional constipation (ie, control group), among which separation anxiety, generalised anxiety, and OCD were significantly different in the two groups

The most common functional gastrointestinal problem in the world is functional constipation. "Ayarij-e-Faiqra (AF)" is a polyherbal formula that has been recommended by Persian Medicine as an efficent purgative agent . The purpose of this study was to evaluate the effect of AF on functional constipation using a double-blind, placebo-controlled clinical trial. According to the Rome III classification, 79 adults with functional constipation were included in this trial. The diagnostic criteria were according to the Rome III classification. Patients with constipation symptoms who referred to the traditional medicine clinic of Shahid Beheshti University of Medical Sciences from April 2014 to September 2016 were randomly allocated to the AF and placebo groups. The AF and placebo groups received AF and placebo for three months, respectively and followed up for another three months. During the study, the treatment efficacy was assessed by a questionnaire. AF treatment significantly decreased most of the symptoms by 84% at the end of the first month (p < 0.05) and by 90% at the end of the third month in comparison to placbo group (p < 0.001). However, three months after the end of the intervention, the frequency of constipation symptoms in both groups was not statistically significant. Based on the satisfaction questionnaire, the treatment satisfaction score during the intervention was increased to 9 in the AF group, but no significant difference was found between the two groups three months after the intervention (p > 0.005). Although AF could be beneficial for treating functional constipation without significant side effects, changing patients’ lifestyles has  great importance in this process.

Both Functional constipation and attention deficit hyperactivity disorder (ADHD) have a high prevalence among children. The aim of this study was to determine the relationship between functional constipation and ADHD.

In this case-control study, 4-12-year-old children who were diagnosed with functional constipation were included in the case group and children with no functional constipation were included in the control group. Diagnosis of functional constipation was performed according to ROME III criteria. All participants were interviewed for ADHD using the Persian version of Conners’ Parent Rating Scale (short form). Statistical analysis was performed by Chi-square test for investigating the relationship between functional constipation and ADHD.

A total of 100 children with functional constipation and 147 children without constipation were selected. Among the functional constipation group, 27 (27%) had a high score for ADHD and among the group without functional constipation, 16 (10.0%) had a high score for ADHD. The odds ratio was 3.028 (95% confidence interval = 1.532-5.986; P value = 0.001). There was no statistically significant relationship between constipation and ADHD considering the age and gender.

Functional constipation has a relationship with ADHD. The chance of having ADHD is 3 times higher in children with functional constipation. Further studies, particularly cohort studies, are recommended to assess the incidence of ADHD symptoms in infants with functional constipation in the future. Further studies on the possible pathophysiology of the digestive system and bacterial intestinal flora, especially in early childhood and infancy, are suggested for investigating the development of behavioral disorders and ADHD.

Constipation is one of the most common issues in pediatrics. The aim of this study was to compare the effect of polyethylene glycol and the simultaneous administration of polyethylene glycol along with probiotics in the treatment of chronic functional constipation.

In this randomized double-blind clinical trial, 150 children with chronic functional constipation referred to Imam Ali Clinic affiliated with Shahrekord University of Medical Sciences from 2017 to 2018 were included. The first group (A) consumed 1 g/ kg of body weight per day of water-soluble polyethylene glycol powder and the second group (B) consumed a probiotic powder and 1 g/kg of body weight of the water-soluble polyethylene glycol powder daily. In weeks 0, 1, and 2, questionnaires were filled out by the parents of the children and the data were analyzed.

The results showed that there was no significant difference in any of the variables between groups A and B (P=0.07) including the frequency of fecal excretion in week 1 (77% and 71%) and week 2 (4% and 5.4%) and stool consistency in week 1 (4% and 6.7%) and week 2 (86.7% and 92%). Moreover, there was no significant difference between groups A and B in any of the variables frequency of painful excretion in week 1 (74% and 73%, respectively) and week 2 (5.3% and 4%, respectively), frequency of abdominal pain in week 1 (61.3% and 49.3%, respectively) and week 2 (4% and 5.3%, respectively), and the frequency of fecal incontinence in week 1 (22.77% and 18.7%, respectively) and week 2 (6.7% and 1.3%) (P>0.05, respectively).

Our results indicated that the administration of probiotic supplement (Lactobacillus Rhamnosus, Lactobacillus acidophilus, Lactobacillous Bulgaricus) has no effect on the improvement of symptoms in children with chronic constipation.

Previous studies report an association between joint hypermobility (JH), as a hallmark of connective tissue disorder, and autonomic dysfunction, digestive problems, and irritable bowel syndrome. However, its association with functional constipation (FC) has not been evaluated. This study is run and implemented to justify this theme/topic.

In this case–control study among 200 subjects, 100 were of FC according to the ROME III Criteria (case group) and each child was matched for age and gender with a healthy control that did not meet criteria for FC (control group). The demographic information and JH were assessed and compared in both groups, through a physical examination according to the Beighton score.

A total of 200 children with a mean age of 6.2 ± 2.2 years constituted the statistical population. The prevalence of JH was assessed to establish the Beighton score (≥4 was considered JH). There was no significant difference in JH between children with and without FC, odds ratio (OR) 1.13 (95% confidence interval [CI]: 0.65–1.98, P = 0.669). There was no significant difference in terms of gender and age between the two groups (P = 0.887, P = 0.396, respectively). JH was not significantly associated with gender (P = 0.445) while significantly associated with age (P = 0.041). Furthermore, there was no significant association between JH and FC (P = 0.669). Following multivariate logistic regression analysis between the presence of JH as the dependent variable and the measured variables as the independent variables, only age had significant independent predictive values in the development of JH (P = 0.041, OR =0.88 [0.77–1]). The obtained adjusted OR in this study indicated that at each year age increase the JH risk decreased by 12%.

Here, it is revealed that the relative frequency of JH in this age range, with and without FC, is not significantly different, and it is not significantly associated with gender while significantly associated with age. 

Gut microbiota influences our health via multiple mechanisms. Microbiota produced Short Chain Fatty Acid (SCFA) as an energy to maintain gut ecosystem and physiology. Dysbiosis is correlated with SCFA imbalance which in turn resulted in physiological abnormalities in the intestine, such as functional constipation.

Randomized Double-Blind Controlled Trial (RCT) was conducted on women with functional constipation (n=37) in the community of Jakarta and profile of SCFA was assessed by using GC-MS from the stool after 21 days supplementation of fermented milk (placebo and probiotic).

Probiotic supplementation significantly influenced acetate titer (p=0,032) marginally significant for propionate and butyrate (p=0.063 and p=0.068, respectively) and the respondent with increasing SCFA’s metabolite are higher in probiotic group compared to the respondents in placebo group. Acetate is the highest SCFA titer found in faeces samples of women with functional constipation.

Probiotic Lactobacillus plantarum IS 10506 supplementation influenced all the SCFA parameter (acetate, propionate and butyrate).

Child abuse is a serious global problem and can be in the form of physical, sexual, emotional or neglect by not providing for the child's needs. Functional constipation (FC) is a common functional gastrointestinal (GI) disorder in children. This study was aimed to assess the relationship between child abuse and functional constipation in children. Materials and Methods In this age frequency-matched case-control study, 100 children with FC were compared with 100 healthy children as control. The diagnosis of FC was based on history and physical examination. Child abuse in three sub-groups (physical, emotional and neglect) were assessed by ISPCAN Child Abuse Screening Tool Children's Version (ICAST-C). The data were analyzed by Stata software (version 13.0). The results of this study revealed that the frequency of any kind of child abuse in case (children with functional constipation), and control group (children without functional constipation) is 93% and 84%, respectively, OR: 2.53 (95% CI: 1.00-6.45), P=0.052. The most frequent abuse in both groups was emotional abuse (91% vs. 81%) followed by physical (61% vs. 47%), and neglect (19% vs. 8%). There was a significant association between frequency of emotional (OR: 2.37, P=0.046), physical (OR: 1.76, P=0.048) and neglect abuse (OR: 2.70, P=0.027) among case and control groups. However, after controlling the confounding variables, the association between child abuse and FC remained clinically important but was not statistically significant (P>0.05). Conclusion Notwithstanding emotional abuse, physical abuse and child neglect rate were more frequent among children with FC, this study demonstrates that child abuse is not associated with FC occurrence.

Assessing the relation between dietary habits and functional gastrointestinal disorders (FGIDs) is less investigated among military personnel. In this study, we aimed to evaluate the association of certain eating patterns and FGIDs in Iranian army men.

This cross-sectional study was performed on 600 army personnel working in Kerman ground forces military station number 05, Iran. Participants were asked to define their weekly breakfast consumption, lunch intake time, and chewing efficiency. FGIDs were categorized as four groups including functional dyspepsia (FD), irritable bowel syndrome (IBS), functional constipation (FC) and functional diarrhea (FDi) diagnosed by Rome Ш criteria. Relation between variables was assessed through crude and multiple stepwise adjusted models.

The prevalence of FD, IBS, FC, and FDi in our study was 20%, 32.3%, 3%, and 53.2%, respectively. After adjustment of all potential confounding variables, more weekly breakfast consumption was associated with decreased FDi prevalence (odds ratio [OR]: 0.57, 95% confidence interval [CI] = 0.38–0.84, P = 0.005). Slowly lunch consumption declined prevalence of IBS (OR: 0.33, 95% CI = 0.13–0.84, P = 0.02). Individuals chewing their meals well had a lower percentage of IBS, FC, and FDi (OR: 0.53, 95% CI = 0.33–0.83, P = 0.006; OR: 0.24, 95% CI = 0.06–0.89, P = 0.03; and OR: 0.52, 95% CI = 0.34–0.79, P = 0.003, respectively).

This study suggested that increasing breakfast intake, slowly lunch consumption, and better food chewing could be effective decreasing FGIDs' prevalence and increasing army crews' quality of lives and work efficiency. Further studies required to confirm this relationship and define accurate pathophysiological mechanisms.

Lubiprostone is considered as a useful laxative for functional constipation in adults. However, although lubiprostone is described in the Guideline of Pediatric Chronic Functional Constipation Treatment (Japanese), it has never been used as a pediatric medicine in Japan because there is no clinical usage experience in children. Here, the current research describes the first pediatric experience of lubiprostone in Japan, with a focus on measures against lubiprostone-induced nausea. Lubiprostone 24-µg capsules, 0.38 to 1.06 µg/kg/time, were used with eight administrations in six patients with intractable functional constipation. All administrations improved defecation, fecal frequency, and the Bristol stool scale score. Complete remission was obtained within four months in five patients (83.3 %). Lubiprostone-induced nausea occurred in two administrations of greater than 0.69 µg/kg/time. However, a dose of 0.90 µg/kg/time with simultaneous administration of trimebutine maleate did not induce nausea in one repeat administration. Lubiprostone is useful for intractable functional constipation in children.

Constipation is a common problem among children. This study aimed to identify the factors related to the duration of chronic functional constipation.

The study was conducted on 826 children with chronic functional constipation referring to a pediatric gastrointestinal (GI) clinic in Fars province. The inclusion criteria of the study were suffering from constipation not due to anatomical (Hirschsprung’s disease and spinal disease) and organic reasons (non-functional constipation), not suffering from other systemic disorders (hypothyroidism and psychomotor retardation), not having the history of prior anal surgery, and not using drugs inducing constipation. The data were analyzed using a linear regression analysis.

This study was performed on 826 children with chronic functional constipation with the mean age of 4.98 + 2.74 years. Among the study children, 418 (50.6%) were boys. Based on the results of multivariate linear regression analysis, the duration of chronic constipation was related to children’s age (B = 0.695 [P < 0.001]), intervals between defecations (B = 0.158 [P = 0.036]), age at the onset of defecation control (B = 0.15 [P = 0.050]), intervals of cereals consumption (B = 0.345 [P < 0.001]), and mother’s education level (B = 0.283 [P = 0.001]). Accordingly, every year increase in children’s age was accompanied by 8.5 months of constipation. In addition, every unit increase in the consumption of cereals during the week (every day, three days a week, once a week, and rarely) caused a four-month increase in chronic constipation.

With increasing age, children need parental care to prevent the occurrence of chronic constipation. Moreover, increasing interest in video games has been accompanied by a decrease in physical activity, which requires more attention from parents

This study aimed to determine effects of synbiotics on treatment of functional constipation in children aged 2-10 years old.
This randomized single blind clinical trial study carried out on children who had functional constipation based on the Rome III criteria. The polyethylene glycol synbiotic group (P group, n=38)received the synbiotic with polyethylene glycol 0.6 gr/kg daily for 4 weeksfollowed bytonly polyethylene glycol for the following four weeks. The polyethylene glycol group (P group n=41) received polyethylene glycol for eight weeks. Then 8 after treatment, frequency of defecation, stool consistency, pain during defecation, fecal constipation and the percentage of patients who needed to continue their drug after 12 weeks treatment were compared between two groups.
The differences in the mean frequencies of defecation (P=0.36), stool consistency (P>0.05), pain during defecation (P>0.05), incontinence (P>0.05) between the two groups at the end of eight weeks were not significant (P>0.05). The end of 12 weeks, 27.8% of (P S) group and 15.6% of (P) group needed to continue medication more than one time /week (P>0.05).
In this study,adding synbiotic to polyethylene was not more effective than only polyethylene in the treatment of childhood functional constipation.

Functional constipation is one of the most common health problems in older adults. Its development greatly depends on nutritional status in that a high fiber diet including fruits and vegetables can prevent or manage it. The present study aimed at assessing vegetable and fruit consumption among the elderly with functional constipation, based on the health belief model.
This was a cross-sectional study conducted on 163 elderly people aged 60 and older, who referred to retirement houses located in Isfahan, Iran, in 2013. The Rome III diagnostic criteria were used for functional constipation screening. Moreover, a demographic questionnaire, a researcher-made questionnaire developed based on the constructs of the health belief model, and a researcher-made 24-hour fruit and vegetable consumption checklist were used for data collection. Data analysis was done using SPSS Software (V, 20.0) and by running independent sample t test, Pearson correlation analysis, one-way analysis of variance, and multiple linear regression analysis at a significance level of less than 0.05.
The mean of participants’ age was 70.04 ± 6.41, while the means of their fruit consumption and vegetable consumption were 1.61 ± 0.73 and 1.31 ± 0.87 servings daily, respectively. Almost 44.2% of the participants consumed less than 2 servings of fruits and 55.8% consumed less than 2 servings of vegetables daily. Fruit and vegetable consumption was directly correlated with perceived susceptibility, perceived severity, perceived self-efficacy, perceived benefits, and knowledge and was inversely correlated with perceived barriers (P This study revealed that the elderly with functional constipation consume inadequate amount of fruits and vegetables and the health belief model is a significant predictor of fruit and vegetable consumption among the elderly. Educational interventions based on the health belief model can be helpful in promoting the consumption of fruit and vegetable consumption in the elderly.