Therapy of chronic functional constipation in children before and after dietary education
Background: The prevalence of chronic constipation in children has been reported between 0.3 and 28%. This study was conducted in southern Iran to compare the effect of a balanced and high fiber diet in children with chronic functional constipation.
Methods: During summer 2007, all children (60) who referred to the Pediatric Department of Mottahari Clinic affiliated to Shiraz University of Medical Sciences and were diagnosed with chronic functional constipation entered this study. A questionnaire on the child's routine dietary regime was filled in for each child through face to face interviews with the parents. The questionnaire included demographic information, food habits, physical exam, and the para-clinical results of each participant. 30 parents were trained to supply a high fiber diet for their children, and its effect on chronic functional constipation was followed after two months. The children of these parents were considered as the case group and the other 30 children were considered as the control group.
Results: Before the parents were educated, the amount of fiber intake from fruits and vegetables by the children was 7.6±2.1 gr. in the case group which increased to 24.25±2.3 gr. after 2 months of training. The amount of water intake was 280 ml before training which increased to 600 ml afterwards and that of milk and yoghurt intake was 280 and 240 ml which decreased to 60 and 200 ml after training, respectively. The amount of beverage and fruit juice intake was 280 and 220 ml while after training it decreased to 100 and 60 ml, respectively. In the case group, 10% of the children had 3 to 6 times defecation per week before the intervention while this increased significantly to 56.7% of the children after the training. The stool consistency significantly changed from very firm to normal and soft consistency after training and the times of stool defecation increased significantly, too. The children's nutrition status changed from a poor state to a good status after training.
Conclusion: Drug treatment was more effective in children that consumed high-fiber diet. It was shown that some of these changes were significant. The difference between the two groups was not, of course, significant which might be due to the small sample size.