.: ORİJİNAL ARAŞTIRMA
Fonksiyonel Konstipasyonu Olan Çocuklarda 0-2 Yaştaki Etiyolojik Faktörlerin Değerlendirilmesi: Kesitsel Araştırma
Evaluation of Etiological Factors at Age 0-2 in Children with Functional Constipation: Cross-Sectional Study
Turkiye Klinikleri J Pediatr. 2023;32(3):113-21
doi: 10.5336/pediatr.2023-96849
Makale Dili: TR
Tam Metin
Ücretsiz Erişim
ÖZET
Amaç: Bu çalışmanın amacı, fonksiyonel konstipasyonu olan çocuk hastalarda 0-2 yaştaki etiyolojik faktörlerin belirlenmesidir. Gereç ve Yöntemler: Ekim 2016-Haziran 2021 tarihleri arasında Gülhane Eğitim ve Araştırma Hastanesi Çocuk Gastroenteroloji Polikliniğine konstipasyon şikâyeti ile başvuran ve Roma IV kriterlerine göre fonksiyonel konstipasyon tanısı alan, 0-18 yaş arası 530 hasta çalışmaya dâhil edildi ve bu hastaların 0-2 yaş dönemlerindeki etiyolojik faktörler değerlendirildi. Bulgular: Çalışmaya dâhil edilen hastaların, %52,6'sı kız idi. Hastaların %56,2'si ilk 24 ayda fonksiyonel konstipasyon tanısı almıştı ve %52,5'i sezaryen doğumdu. İlk 2 yaşta inek sütü alım oranı %52,3, ilk 6 ayda formül mama alan hasta oranı %45,7 idi. Hastaların %3,2'sinde de inek sütü protein alerjisi öyküsü mevcuttu. Tamamlayıcı beslenmeye 6. ayda başlanan hasta oranı %61,1 idi. İlk 2 yaşta; probiyotik kullanım oranı %26,2 idi. 0-2 yaş grubunda poliklinik başvuru sayısının daha fazla olduğu görüldü (p<0,001). Fonksiyonel konstipasyonu olan hastalarda probiyotik kullanım oranının anlamlı düşük olduğu görüldü (p<0,001). İlk 6 ay formül mama alanlarda konstipasyonun daha sık görüldüğü saptandı (p=0,014). Tamamlayıcı beslenme döneminde gluten içeren besinlerin verilme zamanının (p=0,13) ve tamamlayıcı beslenmeye geçiş döneminin (p=0,47) fonksiyonel konstipasyon üzerine etkisi gözlemlenmedi. Sonuç: Fonksiyonel konstipasyonun her yaşta görülmesine karşın, 0-2 yaşta daha sık olduğu ve bu grupta poliklinik başvuru sayısının daha fazla olduğu görüldü. Fonksiyonel konstipasyonu olan hastalarda probiyotik kullanım oranının anlamlı düşük olduğu görüldü ve ilk 6 ay formül mama alanlarda konstipasyonun daha sık görüldüğü saptandı. Tamamlayıcı beslenme döneminde gluten içeren besinlerin verilme zamanının ve tamamlayıcı beslenmeye geçiş döneminin fonksiyonel konstipasyon üzerine etkisi gözlemlenmedi.
Anahtar Kelimeler: Fonksiyonel konstipasyon; etiyolojik faktörler; çocuk; 0-2 yaş
Amaç: Bu çalışmanın amacı, fonksiyonel konstipasyonu olan çocuk hastalarda 0-2 yaştaki etiyolojik faktörlerin belirlenmesidir. Gereç ve Yöntemler: Ekim 2016-Haziran 2021 tarihleri arasında Gülhane Eğitim ve Araştırma Hastanesi Çocuk Gastroenteroloji Polikliniğine konstipasyon şikâyeti ile başvuran ve Roma IV kriterlerine göre fonksiyonel konstipasyon tanısı alan, 0-18 yaş arası 530 hasta çalışmaya dâhil edildi ve bu hastaların 0-2 yaş dönemlerindeki etiyolojik faktörler değerlendirildi. Bulgular: Çalışmaya dâhil edilen hastaların, %52,6'sı kız idi. Hastaların %56,2'si ilk 24 ayda fonksiyonel konstipasyon tanısı almıştı ve %52,5'i sezaryen doğumdu. İlk 2 yaşta inek sütü alım oranı %52,3, ilk 6 ayda formül mama alan hasta oranı %45,7 idi. Hastaların %3,2'sinde de inek sütü protein alerjisi öyküsü mevcuttu. Tamamlayıcı beslenmeye 6. ayda başlanan hasta oranı %61,1 idi. İlk 2 yaşta; probiyotik kullanım oranı %26,2 idi. 0-2 yaş grubunda poliklinik başvuru sayısının daha fazla olduğu görüldü (p<0,001). Fonksiyonel konstipasyonu olan hastalarda probiyotik kullanım oranının anlamlı düşük olduğu görüldü (p<0,001). İlk 6 ay formül mama alanlarda konstipasyonun daha sık görüldüğü saptandı (p=0,014). Tamamlayıcı beslenme döneminde gluten içeren besinlerin verilme zamanının (p=0,13) ve tamamlayıcı beslenmeye geçiş döneminin (p=0,47) fonksiyonel konstipasyon üzerine etkisi gözlemlenmedi. Sonuç: Fonksiyonel konstipasyonun her yaşta görülmesine karşın, 0-2 yaşta daha sık olduğu ve bu grupta poliklinik başvuru sayısının daha fazla olduğu görüldü. Fonksiyonel konstipasyonu olan hastalarda probiyotik kullanım oranının anlamlı düşük olduğu görüldü ve ilk 6 ay formül mama alanlarda konstipasyonun daha sık görüldüğü saptandı. Tamamlayıcı beslenme döneminde gluten içeren besinlerin verilme zamanının ve tamamlayıcı beslenmeye geçiş döneminin fonksiyonel konstipasyon üzerine etkisi gözlemlenmedi.
Anahtar Kelimeler: Fonksiyonel konstipasyon; etiyolojik faktörler; çocuk; 0-2 yaş
ABSTRACT
Objective: The aim of this study is to determine the etiological factors at the age of 0-2 in pediatric patients with functional constipation. Material and Methods: Between October 2016 and June 2021, 530 patients aged 0-18 years, who applied to the Gülhane Training and Research Hospital, Pediatric Gastroenterology Outpatient Clinic with a complaint of constipation and were diagnosed with functional constipation according to the Rome IV criteria were included in the study and the etiological factors in the 0-2 years of age of these patients were evaluated. Results: 52.6% of the patients were girls. 56.2% of the patients were diagnosed in the first 24 months and 52.5% were cesarean delivery. The rate of cow's milk intake in the first 2 years was 52.3%, and the percentage of patients taking formula in the first 6 months was 45.7%. 3.2% of the patients had a history of cow's milk protein allergy. The percentage of patients who started complementary feding at the 6th month was 61.1%. In the first 2 years; the probiotic use rate was 26.2%. It was observed that the number of outpatient clinic visits was higher in the 0-2 age group (p<0.001). It was observed that the rate of probiotic use was significantly lower in patients with functional constipation (p<0.001). Constipation was found to be more common in those who received Formula for the first 6 months (p=0.014). The time of giving gluten-containing foods during the complementary feeding period (p=0.13) and the transition period to complementary feeding (p=0.47) had no effect on functional constipation. Conclusion: Although functional constipation is seen at all ages, it was seen to be more common in 0-2 years of age and the number of outpatient visits was higher in this group. It was observed that the rate of probiotic use was significantly lower in patients with functional constipation, and constipation was found to be more common in those who received formula for the first 6 months. No effect of the timing of giving gluten-containing foods during the complementary feeding period and the transition period to complementary feeding on functional constipation was observed.
Keywords: Functional constipation; etiological factors; child; 0-2 years
Objective: The aim of this study is to determine the etiological factors at the age of 0-2 in pediatric patients with functional constipation. Material and Methods: Between October 2016 and June 2021, 530 patients aged 0-18 years, who applied to the Gülhane Training and Research Hospital, Pediatric Gastroenterology Outpatient Clinic with a complaint of constipation and were diagnosed with functional constipation according to the Rome IV criteria were included in the study and the etiological factors in the 0-2 years of age of these patients were evaluated. Results: 52.6% of the patients were girls. 56.2% of the patients were diagnosed in the first 24 months and 52.5% were cesarean delivery. The rate of cow's milk intake in the first 2 years was 52.3%, and the percentage of patients taking formula in the first 6 months was 45.7%. 3.2% of the patients had a history of cow's milk protein allergy. The percentage of patients who started complementary feding at the 6th month was 61.1%. In the first 2 years; the probiotic use rate was 26.2%. It was observed that the number of outpatient clinic visits was higher in the 0-2 age group (p<0.001). It was observed that the rate of probiotic use was significantly lower in patients with functional constipation (p<0.001). Constipation was found to be more common in those who received Formula for the first 6 months (p=0.014). The time of giving gluten-containing foods during the complementary feeding period (p=0.13) and the transition period to complementary feeding (p=0.47) had no effect on functional constipation. Conclusion: Although functional constipation is seen at all ages, it was seen to be more common in 0-2 years of age and the number of outpatient visits was higher in this group. It was observed that the rate of probiotic use was significantly lower in patients with functional constipation, and constipation was found to be more common in those who received formula for the first 6 months. No effect of the timing of giving gluten-containing foods during the complementary feeding period and the transition period to complementary feeding on functional constipation was observed.
Keywords: Functional constipation; etiological factors; child; 0-2 years
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