Medical Journal of The Islamic Republic of Iran (MJIRI)

  Abstract

  Background: Childhood constipation is a common problem, accounting for 3% of

  visits to pediatric clinics and up to 25% of visits to pediatric gastroenterologists. However, little is known about the prevalence of childhood constipation in developing countries and the frequency of its causes. We proposed to determine the frequency and causes of constipation in children presented to a gastroenterology clinic of a teaching pediatric hospital located in Tehran, Iran.

  Methods: All five hundred and fifty six children referred to a pediatric gastroenterology

  clinic were evaluated for gastrointestinal problems including difficulties in defecation.

  After the detection of constipated children, a questionnare was completed including baseline characteristics, physical examination, paraclinic laboratory data and determination of the cause of constipation (organic or non-organic).

  Results: Out of all 556 children, constipation was diagnosed in 87 individuals

  (15.64%). Among children with constipation, 53% were girls and 47% were boys and only in 13% organ problems was the main cause. Urinary incontinence and encopresis were detected in 16.2% and 27% of constipated children, respectively. The prevalence of urinary tract infection in children with constipation was significantly higher in girls than

  boys (P<0.05).

  Conclusion: The results of our study show that the prevalence of constipation among

  Iranian children is high enough to emphasize it's importance.

  Background: Dyssynergic defecation is a major cause of chronic functional constipation as a common digestive complaint. We clinically evaluated the effects of biofeedback therapy on the pelvic floor motion indices through magnetic resonance (MR) defecography, quality of life and depression in patients with dyssynergic defecation.

  Methods : In this clinical trial study, among patients referring to the Colorectal Clinic of HazratRasoul Hospital, 22 subjects were randomly assigned into two equal groups (n=11) to receive either standard only or biofeedback and standard therapy. Dynamic changes of the pelvic floor were measured by MR defecography. During the simulated defecation, two MR defecography dynamic indices including abnormal anorectal angle change and perineal descent were measured before and after treatment. The effects of biofeedback therapy on patients’ symptoms, quality of life and severity of depression were assessed and compared with the standard therapy. Statistical analysis was carried out using independent _t-test and Mann-Whitney test.

  Results : Paradox index (p< 0.001), perineal descent index (p< 0.001), depression (p< 0.1), physical function (p<0.001), vitality (p< 0.001) and role emotion (p< 0.001) significantly improved in the biofeedback therapy group in contrast to the standard therapySDT group.

  Conclusion : Biofeedback therapy appears to be effective in improving symptoms of functional constipation and dysfunction of pelvic floor motion as well as patient’s quality of life and depression state. MR defecography is able to show the changes in dynamic indices of the pelvic floor through biofeedback therapy.

Background: Constipation is one of the most common gastrointestinal discomforts that affects various age groups in humans. Different mechanical cleansing devices have been introduced yet. However, they are very expensive and not available in our country.
   Methods: This was a pilot experimental trial. Fifteen patients with eligible ROME III criteria and at least two years of chronic constipation and resistant to medical therapy entered the study. Wexner and Longo's scores were checked before and after using the “Roodeshur” device. Data entered SPSS 16 and analyzed using T-test. A p value below 0.05 was considered as a statistically significant difference.
   Results: Five patients were female and 10 males. The mean age of patients was 53.56±18.34 years. There was a significant difference regarding intestinal movement before and after using the device (p˂0.001). Wexner's score decreased after the intervention with a significant difference (p˂0.001).
   Conclusion: Our mechanical cleansing device (Roodeshur) was effective and safe for patients with resistance constipation. No complication occurred. Due to its low cost and easy access in our country, it can be recommended for other patients as well. However, more studies with a larger sample size are recommended.