Clinical Review
The American Journal of Gastroenterology (2006) 101, 2401–2409; doi:10.1111/j.1572-0241.2006.00771.x
Epidemiology of Childhood Constipation: A Systematic Review
Maartje M van den Berg MD1, M A Benninga MD, PhD1 and C Di Lorenzo MD2
- 1Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
- 2Department of Pediatrics, Division of Gastroenterology, Children's Hospital, Columbus, Ohio
Correspondence: Maartje M van den Berg, MD, Emma Children's Hospital, Academic Medical Center, Department of Pediatric Gastroenterology and Nutrition, Room C2-312, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Received 15 November 2005; Accepted 7 May 2006.
Abstract
OBJECTIVE:
A systematic review of the published literature was performed to assess the prevalence, incidence, natural history, and comorbid conditions of functional constipation in children.
METHODS:
Articles were identified through electronic searches in Medline, Embase, Cochrane Central Library, Cinhal and PsychInfo databases. Study selection criteria included: (1) epidemiology studies of general population, (2) on the prevalence of constipation without obvious organic etiology, (3) in children from 0 to 18 yr old, and (4) published in English and full manuscript form.
RESULTS:
Eighteen studies met our inclusion criteria. The prevalence of childhood constipation in the general population ranged from 0.7% to 29.6% (median 8.9; inter quartile range 5.3–17.4). The prevalence of constipation defined as defecation frequency of <3/wk varied from 0.7% to 29.6% (median 10.4; inter quartile range 1.3–21.3). Identified studies originated from North America (N = 4), South America (N = 2), Europe (N = 9), the Middle-East (N = 1), and Asia (N = 2). Variance of gender specific prevalence was reported in seven studies and five of seven studies reported no significant difference between boys and girls. The age group in which constipation is most common could not be assessed with certainty. Socioeconomic factors were not found to be associated with constipation.
CONCLUSION:
Childhood constipation is a common problem worldwide. Most studies report similar prevalence rates for boys and girls. Large epidemiologic studies with the use of generally accepted diagnostic criteria are needed to define the precise prevalence of constipation.
