Factors associated with the stool characteristics of children with cerebral palsy and chronic constipation.

Abstract

espanolIntroduccion: el estrenimiento cronico es un problema gastrointestinal comun en los ninos con paralisis cerebral infantil. Varios factores pueden influir en la frecuencia, la consistencia y el pH de las evacuaciones. Objetivo: identificar la asociacion entre factores dieteticos, uso de anticonvulsivantes y antecedentes familiares con las caracteristicas de las evacuaciones en ninos con paralisis cerebral infantil y estrenimiento cronico. Material y metodos: estudio transversal analitico en 45 ninos con paralisis cerebral y estrenimiento cronico (19 ninas y 26 ninos) con edad de 37 ± 13 meses. Se analizaron factores dieteticos, uso de anticonvulsivantes y antecedentes familiares. Se determinaron la frecuencia de las evacuaciones, la consistencia (escala Bristol) y el pH de las heces (con un potenciometro). Resultados: hubo correlacion positiva entre la frecuencia de las evacuaciones y el consumo de oleaginosas (r = 0,339, p = 0,023). Existio correlacion negativa entre las heces duras y la ingestion de liquidos (r = -0,336, p = 0,042); y entre el pH de las heces y el consumo de cereales ricos en fibra insoluble, las verduras ricas en fibra soluble, la zanahoria y la papa (r = -0,339, p = 0,030; r = -0,308, p = 0,044; r = -0,336, p = 0,027; y r = -0,307, p = 0,045, respectivamente). Se identifico asociacion entre el uso de la politerapia anticonvulsivante y la consistencia dura de las evacuaciones (OR = 14,2 [IC 95% 1,16-174], p = 0,038). No se observo asociacion entre los antecedentes familiares y el estrenimiento. Conclusiones: el consumo de alimentos ricos en fibra, la ingestion de liquidos y la politerapia anticonvulsivante se asocian con las caracteristicas de las evacuaciones en ninos con paralisis cerebral infantil y estrenimiento cronico. EnglishBackground: chronic constipation is a common gastrointestinal problem in children with cerebral palsy and several factors can influence the stool frequency, consistency and pH in these cases. Aim: to identify the association of dietary factors, use of anticonvulsants and family history of constipation with the stool characteristics of children with cerebral palsy and chronic constipation. Methods: an analytical cross-sectional study was performed of 45 children with cerebral palsy and chronic constipation that included 19 females and 26 males, aged 37 ± 13 months. Dietary factors, the use of anticonvulsants and family history were analyzed. Stool frequency, consistency (Bristol Stool Form Scale) and pH (using a pH-meter) were also determined. Results: there was a positive correlation between stool frequency and the consumption of oilseeds (r = 0.339, p = 0.023). There was a negative correlation between hard stools and fluid intake (r = -0.336, p = 0.042) and between stool pH and the consumption of cereals rich in insoluble fiber, high soluble fiber vegetables, carrots and potatoes (r = -0.339, p = 0.030; r = -0.308, p = 0.044; r = -0.336, p = 0.027; r = -0.307, p = 0.045, respectively). An association was also identified between the use of anticonvulsant polytherapy and hard stools (OR = 14.2 [95% CI 1.16-174], p = 0.038). There was no association between family history and constipation. Conclusions: rich-fiber food consumption, fluids intake and anticonvulsant polytherapy were associated with the stool characteristics of children with cerebral palsy and chronic constipation.