Childhood Constipation Just As Serious As Asthma

These findings are a result of a study involving gastroenterologists and researchers at Nationwide Children's to estimate the health care utilization and cost for children with constipation in the United States. The study, available online at PubMed.gov, is slated for publication in The Journal of Pediatrics in early 2009.

Using a nationally representative survey, clinicians and researchers analyzed data of children under 18 years of age who were diagnosed with constipation or prescribed a laxative over two-consecutive years (2003 and 2004). Results showed that children with constipation used more health services than children without the condition, amounting to an additional cost of $3.9 billion each year for children with constipation. Despite this amplified cost impact and its prevalence during childhood, constipation has not received the amount of attention in public health campaigns that similarly occurring asthma and ADHD have.

"Despite being considered by many a relatively benign condition, childhood constipation has been shown to be associated with a significantly decreased quality of life," said the study's author, Carlo Di Lorenzo, MD, chief of Gastroenterology, Hepatology and Nutrition at Nationwide Children's and faculty member at The Ohio State University College of Medicine.

"The day-to-day struggle caused by constipation can often be emotionally devastating, and can also have an impact on the overall health and well-being of affected children and their families."

Researchers and clinicians hope that health care utilization and cost estimates revealed in this study can boost awareness of childhood constipation, awareness that could result in earlier treatment.

"In many cases, constipation in children can be prevented or corrected through dietary and behavioral changes," said Hayat Mousa, MD, a pediatric gastroenterologist at Nationwide Children's Hospital and a faculty member at The Ohio State University College of Medicine.

"Parents should talk to their children about their bathroom habits and make sure they are having a bowel movement at least every other day. For mild cases of constipation, prune or apple juice, high-fiber cereal, or over-the-counter softeners or laxatives made for children may help. If the problem persists, parents should seek the advice of a medical professional."

Personal Story

Car and airplane trips, holiday goodies, new toys, and unfamiliar surroundings. The holidays are a crazy time for kids, often causing their bathroom habits to get out of whack. What might sound like a minor inconvenience is actually a common, sometimes serious problem for children, and not just around the holidays. Now a new study finds childhood constipation is costing us all.

Trips to the bathroom are pretty routine for Kevin Wallace, but it wasn't always that way. A small case of constipation turned into a big problem that took money, time and effort to fix.

"It was very traumatic for both of us, because I'm pushing him to do something and he's telling me he's done it and come to find out he was doing the best he could, I just wasn't aware of the symptoms," says Linda Wallace, Kevin's mother.

And the Wallace's aren't alone. One in four children will have constipation at some point, caused by a number of things like, not eating enough fiber or fruits and vegetables, not wanting to use unfamiliar bathrooms and ignoring the urge to go while playing.

"And children have a very concrete way of thinking. If something doesn't feel good, 'I'll never do that again," says Carlo Di Lorenzo, MD at Nationwide Children's Hospital.

In a new study, Doctor Carlo Di Lorenzo and his team at Nationwide Children's Hospital found constipation can lead to serious health issues and skyrocketing costs, to the tune of nearly four billion dollars a year.* That equals the cost of treating childhood asthma or even ADHD. Di Lorenzo, who is also with the Ohio State University, says parents don't realize constipation can be just as serious. It can result in pain, problems at school, and sometimes the need for surgery.

"It's traumatic to them, then they end up with low self esteem as if something is wrong with them and it's really not," says Hayat Mousa, MD at Nationwide Children's Hospital.

The good news is, most of the time, childhood constipation can be treated with simple changes in diet and behavior, and sometimes mild medication. Now that Kevin is back in his routine, his mom checks in with him regularly, to make sure he stays that way.

Here are some tips for parents: Don't be shy, talk with you children about bowel movements just like you discuss any other bodily function. Make sure your child is going at least every other day. If you find out your child hasn't gone for three to four days, try prune or apple juice, high fiber cereal, or even a warm bath. Over the counter softeners or laxatives made for children can also help.

* Health Utilization and Cost Impact of Childhood Constipation in the United States, slated for publication in The Journal of Pediatrics, early 2009.