This review underscores the negative impact of constipation on children’s well-being and identifies factors associated with lower health-related quality of life in children.
In this systematic review, Vriesman and co-worker’s have pooled together and analyzed data from several studies on health-related quality of life (HRQoL) in children with functional constipation using the PedsQL questionnaire. The effect of bowel dysfunction on children can be measured by the questionnaire that includes social, emotional, school, physical and psychosocial factors. The PedsQL score were significantly reduced in children with functional constipation compared to healthy controls. However, within the group of children with the functional constipation symptoms of fecal incontinence did not affect the HRQoL.
Factors associated with lower HRQoL were psychological maladjustments such as behavioral challenges, and parental factors such as the interaction between child and caregiver. A child’s constipation can impact the entire family and lead to daily conflicts between the child and caregiver. If the symptoms last for a long time it also lowers the quality of life. It can be difficult for the parent to motivate the child to take their daily medication and to do their toilet training. Especially if the medication and toilet training do not ease the symptoms. 40% of children with functional constipation are refractory to treatment in the 6-12 month follow-up period and as many as 25% remain symptomatic into adulthood.