Functional constipation in Thai infants and toddlers: The role of genetic-gut-brain interaction and fiber supplementation.

BACKGROUND

Functional constipation (FC) is a global burden, and data on its prevalence based on Rome IV diagnostic criteria in young children, particularly after the coronavirus disease 2019 era, are limited.

AIM: To determine the prevalence of FC in Thai infants and toddlers using the Rome IV criteria and identify associated factors.

METHODS

The Thai version of the Rome IV Diagnostic Questionnaire for Pediatric Functional Gastrointestinal Disorder (R4PDQ-Toddler) was developed and then officially approved by the Rome Foundation. Guardians of children aged 6-48 months from six hospitals in five regions in Thailand were surveyed between August 2023 and September 2024. The questionnaire collected demographic data, the R4PDQ-Toddler gathered defecation data, and factors potentially associated with FC were recorded.

RESULTS

A total of 1874 guardians participated, yielding a high response rate of 98.1%. The mean age of the children was 20.3 months ± 11.4 months, and 53.5% were male. The prevalence of FC was 16.1% [95% confidence interval (CI), 14.5%-17.8%]. Painful or hard bowel movements (81.5%), large-diameter stools (77.5%), and excessive stool retention (72.2%) were the most common symptoms. Factors independently associated with FC were age > 1 year [adjusted odds ratio (aOR), 3.36; 95%CI: 2.29-4.94], a first-degree relative with a history of constipation (aOR: 2.48; 95%CI: 1.85-3.35), fiber supplementation (aOR: 7.85; 95%CI: 3.56-17.30), and exposure to stressful family events (aOR: 1.41; 95%CI: 1.03-1.92).

CONCLUSION

FC is prevalent in Thai infants and toddlers. Older age, family history, fiber supplementation, and stress are key factors, highlighting genetic, dietary, and gut-brain influences that need further investigations.