Document Type : original article
Authors
1 Department of Pediatrics, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran.
2 Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Science, Shahrekord, Iran. ORCID: 0009-0003-2986-7548.
3 Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
4 Department of Pediatrics, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
Abstract
Introduction: In diagnosing and tracking fecal impaction in children with functional constipation, a set of methods such as history taking, physical examination, digital rectal examination (DRE), and, if necessary, imaging-based methods are used, yet the most effective method for tracking this condition remains unclear. We aimed to assess the agreement of medical history and DRE with trans-abdominal radiography as the gold diagnostic standard to track childhood fecal impaction.
Material and Methods: In this cross-sectional study, two subgroups of children aged 4 to 10 years with and without fecal impaction were included and assessed by physical examination, DRE, and trans-abdominal radiography (as the standard), along with a minute medical history.
Results: The positive abdominal examination in the groups with and without fecal impaction was 33.5% and 7.9%, respectively, indicating a significant difference (p < 0.001). In the groups with and without fecal impaction, positive medical history related to functional constipation was revealed in 85.3% and 4.2%, respectively, indicating a significant difference (p <0.001). Also, in the DRE method, compared to the abdominal radiography, fecal impaction was positive in 85.9% of patients with fecal impact. In comparison, only 8.5% of the control group indicated a significant difference (p < 0.001).
Conclusion: To diagnose fecal impaction in children with functional constipation, a combination of history taking, DRE, and, if necessary, abdominal radiography should be considered.
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