This month the journal Pediatrics published a study of over 9,000 visits to the emergency room at the Children’s Hospital of Pittsburgh, by children 1 to 18 years old with abdominal pain, and discovered that constipation was the most common specific diagnosis, the cause of the pain in more than a quarter of the children who had any diagnosis made.
“Parents are shocked that that’s their child’s diagnosis,” said Dr. Kerry S. Caperell, an assistant professor of pediatrics at the University of Louisville School of Medicine and lead author of the study. The highest rate of constipation, he said, was found in boys around 10. “My experience is the kids don’t like to go to the bathroom at school, so there’s a sort of voluntary retention that exacerbates itself.”
Constipation is children can begin as early as potty training. Children can be extremely hesitant to evacuate bowels, a way of combating control issues with parental agendas.
“We call it defecation anxiety,” says Dr. Jessica Hankinson, a pediatric psychologist at Johns Hopkins Children’s Center. “You have hard, difficult stools to pass, you have a painful bowel movement, you start withholding.” That, in turn, affects the functioning of the colon.
According to the New York Times, Dr. Marc Benninga, a pediatrics professor at the Emma Children’s Hospital, Academic Medical Center, in Amsterdam, and colleagues have studied how chronic constipation affects children over time. “It has a huge impact on both the child and the family,” he said. “If you look at the data, 50 percent of the children with constipation still have complaints of constipation after five years of intensive therapy.”
In a 2010 study by his group, one-fourth of the children still had symptoms in adulthood.And constipation appears to be a serious issue with American adults as well.
“There’s a fairly large literature in adults in terms of the adverse affects of chronic constipation on quality of life,” said Dr. Arnold Wald, a gastroenterologist and professor at the University of Wisconsin School of Medicine and Public Health who has written about constipation in both adults and children. “Many studies have suggested it has an impact consistent with what we see in a lot of chronic illnesses, inflammatory bowel disease and so forth.”