Constipation linked to obesity in children

Children with chronic Constipation are about twice as likely to be obese as their peers without this problem, according to a report in the medical journal Pediatrics.

"When a clinician sees a child with constipation, they should remember to evaluate them for obesity," said lead author Dr. Dinesh S. Pashankar, from Yale University School of Medicine in New Haven, Connecticut. "As most people are aware, obesity is an increasing problem among children and unless there's an issue, like constipation, many obese children simply won't be seen by a clinician."

The new findings also have psychiatric implications, Pashankar emphasized. Individually, "obesity and constipation can cause behavioral issues and Depression, but together the problem is likely to be more severe. Clinicians need to be aware of that."

The researchers compared the prevalence of obesity among 719 children with chronic constipation with no apparent organic cause and among 930 children in the same age group seen at a general pediatrics clinic who were not constipated (control group).

Constipation refers to infrequent or hard stools, or difficulty passing stools. Constipation may involve pain during the passage of a bowel movement, inability to pass a bowel movement after straining or pushing for more than 10 minutes, or no bowel movements after more than 3 days. Infants who are still exclusively breastfed may go 7 days without a stool.
The rate of obesity among the constipated children was 22.4 percent, nearly double the rate seen in control children - 11.7 percent. The association between constipation and obesity was noted in both boys and girls.

The new findings generally support those of a previous study, which examined this topic but did not include a control group, Pashankar pointed out.

Constipation: Common Causes

Constipation is most often caused by a low-fiber diet, lack of physical activity, not drinking enough water, or delay in going to the bathroom when you have the urge to defecate. Stress and travel can also contribute to constipation or other changes in bowel habits.

Other times, diseases of the bowel (such as irritable bowel syndrome), pregnancy, certain medical conditions (like an underactive thyroid or cystic fibrosis), mental health problems, neurological diseases, or medications may be the reason for your constipation. More serious causes, like colon cancer, are much less common.

Constipation in children often occurs if they hold back bowel movements when they aren't ready for toilet training or are afraid of it.

As to the mechanism linking and constipation, Pashankar said that diet is likely a major factor. "Less fiber intake probably results in greater caloric intake and together these dietary patterns cause both problems."