Çocuklarda fonksiyonel konstipasyon
Loading...
Date
2008
Authors
Tanır, Burak
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Giriş/Amaç Çocukluk çağı konstipasyonları, bütün dünyada yaygın olmakla birlikte, halen olguların büyük çoğunluğunda nedenin bulunamadığı ve tedavinin genellikle klinik deneyimlere dayandığı bir sorundur. Çalışmamızda, konstipasyonun, terminolojisi, tedavisi ve takibini standardize etmek amacıyla uluslararası fikir birliği ile oluşturulan Roma III kriterleri kullanılarak klinik sonuçlarımız irdelenmiştir. Gereç ve Yöntem Çalışmaya alınan 41 olgu ( 23 erkek, ortalama yaş 4,7), İnfant Disşezisi (n=14), Fonksiyonel Konstipasyon (n=22) ve Non-retantif Fekal İnkontinans (n=5) olarak adlandırılan üç hastalık grubuna ayrıldı. İnfant Disşezi grubuna tedavi verilmedi, Fonksiyonel Konstipasyon grubunda oral ve rektal laksatiflerden oluşan standart tedavi protokolü uygulandı ve Non-retantif Fekal İnkontinans grubunda ise tedavinin esasını sıkı bir tuvalet eğitimi oluşturdu, medikal tedavi verilmedi. Fonksiyonel Konstipasyonlu olgularda ilk 6 haftalık yoğun tedavi dönemini takiben olgular tedavi başarısına göre üç gruba ayrılarak değerlendirildi. Çalışmamızdaki veriler prospektif ve retrospektif olarak toplanarak, hastalık grupları, tedavi başarı grupları ve relaps olan-olmayanlar arasında; güncel yaş, semptom yaşı, cins, düzensiz/yetersiz tedavi kullanımı, semptomla klinik başvuru arasındaki süre, aile öyküsü, beslenme durumu, tuvalet eğitimi, psikolojik faktör, üriner semptom, aylık fekal inkontinans, takip süresi ve relaps için karşılaştırmalar yapıldı. Bulgular Ortalama 7,2 aylık takip süresi sonunda, İnfant Disşezi grubunda %71,4, Fonksiyonel Konstipasyon grubunda %72,7 ve Non-retantif Fekal İnkontinans grubunda ise %60 olgunun tedavisinde başarılı olundu. Relaps yalnızca Fonksiyonel Konstipasyon grubunda gözlendi (%12,1). Aylık fekal inkontinans sıklığı ve psikolojik faktörlerin pozitifliği prognozu anlamlı ölçüde negatif etkilediği belirlendi (p<0,05). İnfant Disşezi grubundaki olguların %28,6'sı takip sonunda Fonksiyonel Konstipasyon tanısı aldı. Sonuç Roma III kriterleri kullanılarak tanımlanan iki yeni grupta (İnfant Disşezi ve Non-retantif Fekal İnkontinans) ilaçsız tedavi, olguların yarısından fazlasında (Sırayla %71,4 ve %60) başarılı olmuştur. İnfant Disşezi'nin erken bebeklik döneminde tanımlanması gereksiz tedaviyi önlemektedir. Çocukluk çağı defekasyon bozukluğu gösteren her üç olgudan birinin tedaviye dirençli olduğu görülmüştür. İnfant Disşezi tanısı alan olgular fonksiyonel konstipasyon gelişimi açısından yakın takip edilmelidir.
Background Aim Constipation is a common phenomenon in childhood worldwide but its causes and management remain obscure. Treatment is still based on clinical experience. We were evaluated our clinical results to used Roma III criteria that was consisted with international consensus for terminology, treatment and follow-up of constipation. Patients and Methods A total of 41 children that was complaint defecation disorders were divided by three groups: Infant Dyschezia (n=14), Functional Constipation (n=22) and Non-retentive Fecal Incontinence (n=5). Infant Dyschezia was not treated the laxative therapy, Functional Constipation was treated standard treatment protocol that was made oral and rectal laxative therapy and treatment with Non-retentive Fecal Incontinence’s children were consisten of a strict toilet training regimen only, without the use of laxatives. Initially were performed to intensive therapy during the 6-weeks for the Functional Constipation group. Thereafter, these patients were divided by three groups according to success of therapy. All datas were collected prospectively and retrospectively. Actual and symptom age, sex, history of irregular/failed therapy, duration of symptoms before intake in to the study, family history, nutritional status, toilet training, psychological factors, symptoms of urinary tract, fecal incontinence for month, follow-up period and relaps were compared between the groups (Disease, therapy success and with/without relaps). Findings The median duration of the follow-up period was 7,2 months and our cure rates for the Infant Dyschezia, Functional Constipation and Nonretentive Fecal Incontinence groups were 71,4%,72,7% and 60% respectively. The relapse was only detected Functional Constipation (12,1%). Frequency of fecal incontinence and psychological factors were v associated with poor prognosis (p<0,05). Babies of 28,6% with Infant Dyschezia were diagnosed Functional Constipation after the follow-up period. Conclusion Successfull treatment was achieved in two new groups (Infant Dyschezia and Non-retentive Fecal Incontinence) that description with used Roma III criteria without drugs. The cure rates for these groups were 71,4% and 60% respectively. If the Infant Dyschezia was identified in early infancy, might to avoid unnecessary therapy. Despite therapy, chidhood defecation disorders was still present in 1 of 3 children. Babies with Infant Dyschezia were followed closely for development of Functional Constipation.
Background Aim Constipation is a common phenomenon in childhood worldwide but its causes and management remain obscure. Treatment is still based on clinical experience. We were evaluated our clinical results to used Roma III criteria that was consisted with international consensus for terminology, treatment and follow-up of constipation. Patients and Methods A total of 41 children that was complaint defecation disorders were divided by three groups: Infant Dyschezia (n=14), Functional Constipation (n=22) and Non-retentive Fecal Incontinence (n=5). Infant Dyschezia was not treated the laxative therapy, Functional Constipation was treated standard treatment protocol that was made oral and rectal laxative therapy and treatment with Non-retentive Fecal Incontinence’s children were consisten of a strict toilet training regimen only, without the use of laxatives. Initially were performed to intensive therapy during the 6-weeks for the Functional Constipation group. Thereafter, these patients were divided by three groups according to success of therapy. All datas were collected prospectively and retrospectively. Actual and symptom age, sex, history of irregular/failed therapy, duration of symptoms before intake in to the study, family history, nutritional status, toilet training, psychological factors, symptoms of urinary tract, fecal incontinence for month, follow-up period and relaps were compared between the groups (Disease, therapy success and with/without relaps). Findings The median duration of the follow-up period was 7,2 months and our cure rates for the Infant Dyschezia, Functional Constipation and Nonretentive Fecal Incontinence groups were 71,4%,72,7% and 60% respectively. The relapse was only detected Functional Constipation (12,1%). Frequency of fecal incontinence and psychological factors were v associated with poor prognosis (p<0,05). Babies of 28,6% with Infant Dyschezia were diagnosed Functional Constipation after the follow-up period. Conclusion Successfull treatment was achieved in two new groups (Infant Dyschezia and Non-retentive Fecal Incontinence) that description with used Roma III criteria without drugs. The cure rates for these groups were 71,4% and 60% respectively. If the Infant Dyschezia was identified in early infancy, might to avoid unnecessary therapy. Despite therapy, chidhood defecation disorders was still present in 1 of 3 children. Babies with Infant Dyschezia were followed closely for development of Functional Constipation.
Description
Keywords
Çocuklar, Konstipasyon, İnkontinans, Roma III, Disşezi, Children, Constipation, Incontinence, Dyschezia
Citation
Tanır, B. (2008). Çocuklarda fonksiyonel konstipasyon. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi