Occult constipation in children: An unaddressed problem of our day-to-day practice

BACKGROUND In our day-to-day practice, constipation is a common problem in the pediatric population and cause of frequent visit in outpatient and emergency department. But occult constipation (OC) remains as the most unaddressed problem. AIM To investigate the clinical profile of OC in children. METHODS It was a prospective observational study, done in Bangladesh from January 2022 to December 2024. It included all consecutive children diagnosed as OC and were treated accordingly. Before diagnosis, secondary causes of the presenting symptoms were excluded with appropriate investigations. They were followed up monthly for 4 months and treatment response were measured by improvement of symptoms. RESULTS A total of 404 children were included in this study with mean age group of 76.50 ± 36.62 months, and male-female ratio of 1.67:1. The most common presenting complaint was abdominal pain (66%), followed by anorexia (49%), vomiting (24%), nausea (17%), frequent defecation with small volume stool (17%), altered bowel habit (16%), failure to thrive (14%) and recurrent helminthiasis (12%). Interestingly, 2.5% children presented with persistent diarrhea. CONCLUSION Abdominal pain is the most common presentation of OC. When symptoms cannot be explained by other etiology, OC should be kept in mind.