Functional constipation in Bangladeshi school aged children: A hidden misty at community

Table 1 Demographic data of children with functional constipation and without constipation

Characteristics	Functional constipation (n = 78), n (%)	Without constipation (n = 573), n (%)	P value
Sex			0.0031
Male	38 (48.7)	378 (66)
Female	40 (51.3)	195 (34)
Age (mean ± SD, yr)	11.24 ± 3.51	12.67 ± 2.40	0.0012
Place of residence			0.1901
Rural	17 (21.8)	156 (27.2)
Urban	61 (78.2)	417 (72.8)
Religion			0.2141
Muslim	77 (98.7)	551 (96.2)
Hinduism	1 (1.3)	22 (3.8)

¹Chi-square test.

²t–test.

P value < 0.05 considered as statistically significant.

Table 2 Symptoms analysis of children with functional constipation and without constipation

Characteristics	Functional constipation (n = 78), n (%)	Without constipation (n = 573), n (%)	P value
Anorexia			0.0011
Yes	35 (44.9)	124 (21.6)
No	43 (55.1)	449 (78.4)
Nausea			0.0011
Yes	17 (21.8)	46 (8)
No	61 (78.2)	527 (92)
Abdominal pain			0.0011
Yes	37 (47.4)	122 (21.3)
No	41 (52.6)	451 (78.7)
Hard stool			0.0011
Yes	63 (80.8)	32 (5.6%)
No	15 (19.2)	541 (94.4)
Blood with hard stool			0.0011
Yes	6 (7.7)	3 (0.5)
No	72 (92.3)	570 (99.5)
Alternative hard and loose stool			0.0011
Yes	22 (28.2)	10 (1.7)
No	56 (71.8)	563 (98.3)
Abdominal distension			0.5371
Yes	0 (0)	78 (100)
No	78 (100)	566 (98.8)
Fecal mass in LIF			0.0011
Yes	12 (15.4)	0 (0%)
No	66 (84.6)	573 (100)

¹Chi-square test, P value < 0.05 considered as statistically significant.

Table 3 Descriptive data of bowel habits of children with functional constipation and without constipation

Characteristics	Functional constipation (n = 78), n (%)	Without constipation (n = 573), n (%)	P value
Defecation frequency			0.0011
Daily	43 (55.1)	501 (87.4)
1 d interval	3 (3.8)	48 (8.4)
2 d interval	12 (15.4)	24 (4.2)
3 d interval	20 (25.6)	0 (0)
Incontinence			0.0141
Yes	2 (2.6)	0 (0)
No	76 (97.4)	573 (100)
Painful bowel movements			0.0011
Yes	60 (76.9)	2 (0.3)
No	18 (23.1)	571 (99.7)
H/O retentive posturing			0.0011
Yes	7 (9)	0 (0)
No	71 (91)	573
Large diameter stool			0.0011
Yes	72 (92.3)	2 (0.3)
No	6 (7.7)	571 (99.7)

¹Chi-square test, P value < 0.05 considered as statistically significant.

Table 4 School related factors analysis of children with functional constipation and without constipation

Characteristics	Functional constipation (n = 78), n (%)	Without constipation (n = 573), n (%)	P value
Type of school			0.2211
Govt	50 (64.1)	396 (69.1)
Non Govt	28 (35.9)	177 (30.9)
Residential			0.0911
Yes	32 (41)	187 (32.6)
No	46 (59)	386 (67.4)
Long periods of school			0.0131
Yes	13 (16.7)	166 (29)
No	65 (83.3)	407 (71)
Unhygienic toilet			0.0561
Yes	19 (24.4)	93 (16.2)
No	58 (75.6)	480 (83.8)
Toilet number			0.0131
Adequate	64 (82.1)	523 (91.3)
Inadequate	18 (17.9)	50 (8.7)
Feeling embarrassed to use toilet			0.0391
Yes	9 (11.5)	31 (5.4)
No	69 (88.5)	542 (94.6)

¹Chi-square test, P value < 0.05 considered as statistically significant.

Table 5 Family related factors analysis of children with functional constipation and without constipation

Characteristics	Functional constipation (n = 78), n (%)	Without constipation (n = 573), n (%)	P value
History of constipation in other sibling			0.0011
Yes	18 (23.1)	25 (4.4)
No	60 (76.9)	548 (95.6)
History of constipation in parents/grand parents			0.0011
Yes	17 (21.8)	27 (4.7)
No	61 (78.2)	545 (95.1)
Family size			0.2961
Only child	3 (3.8)	28 (4.9)
2-3 child	46 (59)	284 (49.6)
≥ 4 child	29 (37.2)	261 (45.5)
Birth order			0.7941
Elder	29 (37.2)	209 (36.5)
Youngest	27 (34.6)	182 (31.8)
Other	22 (28.2)	182 (31.8)
Mother’s education			0.7971
Primary	59 (75.6)	426 (74.3)
SSC	11 (14.1)	83(14.5)
HSC	5(6.4)	28 (4.9)
Honors	3 (3.8)	36 (6.3)
Father’s education			0.6101
Primary	53 (67.9)	392 (68.4)
SSC	10 (12.8)	82 (14.3)
HSC	9 (11.5)	43 (7.5)
Honors	6 (7.7)	56 (9.8)
Mother’s occupation			0.8311
Employed	9 (11.5)	73 (12.7)
Housewife	69 (88.5)	500 (87.3)
Household income (taka/mo)			0.3931
< 30000	49 (62.8)	384 (67)
30000-60000	23 (29.5)	131 (22.9)
> 60000	6 (7.7)	58 (10.1)
Family status			0.2511
Single	72 (92.3)	510 (89)
Joint	6 (7.7)	63 (11)

¹Chi-square test, P value < 0.05 considered as statistically significant.

Table 6 Diet related factors analysis of children with functional constipation and without constipation

Characteristics	Functional constipation (n = 78), n (%)	Without constipation (n = 573), n (%)	P value
Cow’s milk intake			0.4691
Yes	40 (51.3)	301 (52.5)
No	38 (48.7)	272 (47.5)
Fiber			0.0021
Adequate	45 (57.7)	428 (74.7)
Inadequate	38 (42.3)	145 (25.3)
Junk foods intake			0.3411
Yes	26 (33.3)	209 (36.5)
No	52 (66.7)	364 (63.5)
Fluid intake			0.0011
Adequate	37 (47.4)	424 (74)
Inadequate	41 (52.6)	149 (26)

¹Chi-square test, P value < 0.05 considered as statistically significant.

Table 7 Physical activity related factors analysis of children with functional constipation and without constipation

Characteristics	Functional constipation (n = 78), n (%)	Without constipation (n = 573), n (%)	P value
Games			0.2161
Outdoor	49 (62.8)	0 (0)
Indoor	29 (37.2)	160 (27.9)
Physical disability	0 (0)	2 (0.3)
Electronic screen time			0.0011
< 1 h	42 (53.8)	410 (71.6)
1-2 h	12 (15.4)	87 (15.2)
> 2 h	24 (30.8)	76 (13.2)

¹Chi-square test, P value < 0.05 considered as statistically significant.

Table 8 Binary logistic regression analysis for risk factors

Characteristics	P value	95%CI		Exp ß
		Lower	Upper
Age	0.051	1.000	1.204	1.097
Sex	0.056	0.985	3.280	1.798
Long duration of school period	0.746	0.415	1.876	0.883
Inadequate number of toilet	0.013	1.214	5.120	2.493
Feeling embarrassed to use toilet	0.006	1.435	8.794	3.552
H/O affect sib	0.001	1.884	8.397	3.977
H/O affect parents/grandparents	0.018	1.172	5.629	2.569
Inadequate fiber intake	0.286	0.403	1.307	0.726
Inadequate fluid intake	0.016	1.135	3.426	1.972
Electronic screen time > 2 h/d	0.033	1.063	4.301	2.138

P value < 0.05 considered as statistically significant.