Chronic functional constipation in adolescents: clinical findings and motility studies

Abstract 

Objective

To evaluate the clinical findings and colonic transit time in adolescents with chronic functional constipation.

Methods

Forty-eight consecutive adolescents with chronic functional constipation referred to the Gastroenterology Service at the Hospital de Clínicas de Porto Alegre, Brazil were studied. Clinical parameters were assessed using a questionnaire. Total and segmental colonic transit time were measured with radiopaque markers.

Results

Mean age at first visit was 14 ± 2 years, and age at onset of constipation was 6 ± 4 years; 90% of patients depended on laxatives, and 86% on intermittent enemas; 76% had a family history of constipation. There was no statistical difference in the amount of daily fiber ingested by patients and controls. Measurements of colonic transit time revealed that 60% of patients had slow transit constipation, 13% had pelvic floor dysfunction, 10% had slow transit constipation associated with pelvic floor dysfunction, and 17% had a normal colonic transit time. Decreased frequency of evacuation and palpable abdominal fecal mass were significantly associated with slow transit constipation.

Conclusions

Functional constipation in adolescence consists of a heterogeneous group of colonic functional disorders. The identification of these different functional disorders in adolescents will guide specific treatment, which may prevent the progression of this symptom into adult life.

Keywords:  Adolescents, Clinical findings, Colonic transit time, Functional constipation, Radiopaque markers