Clinical profile of functional constipation in children 6 to 16 years age using the Rome IV criteria: A descriptive cross-sectional study

Background: Functional constipation (FC) is a common cause of abdominal pain in children, with Rome IV criteria as a diagnostic guide. 
Objectives: To study the clinical profile of children with FC as per Rome IV criteria and identify if any association exists with other clinical symptoms.
Method: A cross-sectional study was conducted over one year among children aged 6 to 6 years presenting with functional abdominal pain at a tertiary care hospital. Children with hypothyroidism, neurological conditions and surgical conditions related to the abdomen were excluded. Diagnosis of FC was based on Rome IV criteria. Any possible association between clinical symptoms and Rome IV criteria was analysed using chi-square test.
Results: Eighty children met the inclusion criteria, with a mean age of 10.6 years and a female predominance (51.3%). Common symptoms were abdominal pain (92.5%), hard stools (88%), and urinary tract infections (26.3%). Palpable faecal mass was found in 15%. Painful bowel movements (97.5%) and fewer than 2 weekly bowel movements (77.5%) were the most met criteria under Rome IV. Painful defaecation had statistically significant association with abdominal pain (p=0.021), while infrequent bowel movements had statistically significant associations with urinary incontinence (p =0.046) and faecal incontinence (p<0.001). 
Conclusions: Common symptoms were abdominal pain, passage of hard stools, and urinary tract infections. Palpable faecal mass was found in 15%. Painful bowel movements and fewer than two weekly bowel movements were the most met criteria under Rome IV. Painful defaecation had statistically significant association with abdominal pain, while infrequent bowel movements had statistically significant associations with urinary and faecal incontinence.