DDW: Constipation Tougher to Treat In Overweight Kids

May 20, 2007

WASHINGTON -- Overweight children with constipation tend to fare worse than their normal-weight counterparts, but the reasons may be more psychological than biological, researchers suggested here.

WASHINGTON, May 20 -- Overweight children with constipation tend to fare worse than their normal-weight counterparts, but the reasons may be more psychological than biological, researchers suggested here.

Overweight kids with constipation were about three times more likely to be referred to pediatric GI specialists by their primary care physician than constipated children of normal weight, said senior investigator Sudipta Misra, M.D., of the University of Illinois at Peoria.

However, the overall occurrence of constipation was not significantly different between overweight and normal weight children seen at a primary care clinic, Dr. Misra reported at Digestive Disease Week; it was about 3% for both groups.

The current study follows up on previous research that found that constipation tended to be linked to overweight in pediatric patients. However, those previous studies looked only at children referred to pediatric GI specialists, Dr. Misra said.

The current study is the first to show that the link is not found in a primary care population, he said.

Dr. Misra and his colleagues retrospectively reviewed the charts of 955 children ages five to 18 seen at a primary care clinic in 2003 and 2004. Of these, 319 (or 33.4%) were overweight, which was defined in this study as a BMI in the 85th percentile or higher for their age and sex.

The primary care doctors noted constipation in the charts of nine of those 319 overweight kids (2.8%). Nearly the same percentage of normal-weight kids were also noted to have constipation (19 of 636 children, or 2.98%; P not significant for the comparison).

If there were a biological link between overweight and constipation, the researchers would have expected to find significantly more constipation among the overweight children seen in the primary care setting, Dr. Misra said.

A second chart review of 66 children who had a specific ICD-9 code diagnosis of constipation by a primary care doctor from 1999 through 2004 suggested a different explanation, Dr. Misra said.

The proportion of overweight children in this analysis was about the same as in the first (30.3%). But more than half of these overweight children were referred to a pediatric GI specialist (11 of 20) compared with less than one-third of normal-weight children (13 of 46; odds ratio=3.1; P