Shahrbanoo Nakhaei , Yasamin Mohammadzadeh , Reza Behmadi , Ozra Ebrahimi Nasab, Leila Asgarzadeh ,
Volume 72, Issue 11 (2-2015)
Abstract
Background: Functional constipation and gastroesophageal reflux disease (GERD) are two common childhood digestive disorders which can cause a lot of complications among them if untreated. Since an overlap and relationship between functional gastrointestinal disorders have been shown in some studies, so present study was performed to investigate the frequency of functional constipation among children with reflux in compare with children without reflux.
Methods: A cross-sectional study was conducted on all children who referred to digestive diseases clinic of Ali-Asghar Hospital in Tehran, Iran, from April 2008 to January 2010. Patients that referred for follow up were excluded from study and a total of 474 children were included in this study. A questionnaire including symptoms of reflux and functional constipation was completed for all subjects by design’s executer after parental consent. Other data related to history, physical examination and results of paraclinic investigations for functional constipation diagnosis were also collected.
Results: In general 247 children (52%) were male and 227 children (48%) were female. Nineteen children (4%) had gastroesophageal reflux disease in this study which 6 of them (31.5%) were less than 1 year old and 13 of them (68.5%) were greater than 1 year old. Opisthotonic posturing, abdominal pain, heartburn and recurrent vomiting were the most common symptoms in children with reflux. There was also functional constipation in 60 children. Twelve patients (63.2%) had functional constipation among 19 children with reflux, whereas 48 patients (10.5%) had functional constipation among 455 children without reflux. This different frequency ranges of functional constipation among children with and without gastroesophageal reflux was statistically significant (P= 0.001).
Conclusion: The frequency of functional constipation in children with gastroesophageal reflux was significantly more than normal children. Further studies are recommended to investigate the relationship between functional constipation and gastroesophageal reflux in children.
Razieh Sangsari, Kayvan Mirnia, Maryam Saeedi, Nazi Dezvaree, Fatemeh Kazerooni,
Volume 82, Issue 3 (6-2024)
Abstract
Background: Hirschsprung's disease is a major cause of functional intestinal obstruction, mainly affecting the distal region of the large intestine. Risk factors for this disease include a family history of the disease, being male, and the presence of other conditions such as cardiac or chromosomal abnormalities.
Methods: Infants admitted to Children's Medical Center Hospital, Tehran university of medical science between April 2017 to April 2021 with a diagnosis of Hirschsprung's disease were included in this study. Demographic information, clinical and radiological findings, and complications were recorded on customized forms.
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Results: In this study, 29 neonates were included. The clinical manifestations of Hirschsprung in this study were failure to defecation in the first two days of birth, abdominal distention, and bilious vomiting. The most common complaint at the time of visit was constipation and vomiting, and the most common clinical finding at the time of hospitalization was abdominal distension. The most common radiological manifestation in the simple X-ray of affected neonates was the dilation of the intestinal loops and in the barium enema transitional zone. In the delayed X-ray, the delay in emptying the barium was observed. in neonate with Hirschsprung's disease Heart disease was a common comorbidity (27.2%). The most common heart disease was Atrial Septal Defect (ASD). The most histological involvement was in the rectal and rectosigmoid areas. The most common complication of Hirschsprung in the follow-up of neonates until at least 6 months of age was poor weight gain, constipation and fecal incontinence. We had three deaths, one case with Small intestine, one case with heart disease and one case with multiple anomalies.
Conclusion: The results of this study are consistent with previous research showing that genetic variations do not have a major impact on the clinical presentation of newborns with Hirschsprung's disease. While diagnostic methods like x-ray and contrast enema can be useful, biopsy is the most reliable way to confirm a diagnosis of Hirschsprung's disease. Physicians should consider performing a biopsy when evaluating a suspected case of this condition.
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