Effects of disposable diaper usage on defecation dysfunction in children aged 2 to 6 years: a retrospective epidemiological study

Zhou W1, Li S1, Wen J G2, Wang H1, Chen J1, Liu X1, Jiang J1, Li W1, Sun F1, Diao H1, Yao F1

Research Type

Clinical

Abstract Category

Paediatrics

Abstract 158
Open Discussion ePosters
Scientific Open Discussion Session 7
Wednesday 29th August 2018
12:05 - 12:10 (ePoster Station 10)
Exhibition Hall
Bowel Evacuation Dysfunction Pediatrics Retrospective Study
1. Department of Urology,Shenzhen Children's Hospital,China, 2. Pediatric Urodynamic Center, Department of Urology ,The First Affiliated Hospital of Zhengzhou University,China
Presenter
W

Wei Zhou

Links

Poster

Abstract

Hypothesis / aims of study
In the past two decades, with the rapid economic development, DD has been widely used in newborn baby care. At present, there is still controversy about the use of DD in infants and young children and the start time of toilet training. The increased prevalence of urinary control abnormal diseases such as children's enuresis caused by DD use has attracted widespread attention from international scholars, but it has been shown to be effective in children's defecation. The impact of the prevalence of disorders has not yet been reported in large samples at home and abroad. This study investigated the effects of DD use on the prevalence of defecation dysfunction in children by retrospectively investigating and analyzing the use of DD and toilet training and defecation control in 6030 children aged 2 to 6 years.
Study design, materials and methods
Research object
From January 2017 to October 2017, 6030 healthy children from 2 to 6 years of age in 30 kindergartens were randomly selected from 6 densely populated areas in the city, and retrospective surveys were conducted in the form of anonymous questionnaires. There are more than 150 people in each kindergarten. Using χ2 test, t test for statistical analysis.
Inclusion criteria: Healthy children aged 2-6.
Exclusion criteria: Congenital lumbosacral meningocele, tethered cord and dorsal vertebral dysplasia and other neurological developmental abnormalities, congenital anorectal malformations, congenital megacolon and borderline diseases, pelvic giant tumors, Anal and rectal trauma or anal fistula and surgical history may affect children's disease related to defecation control and their children after surgical treatment.
Survey Methods and Survey Items
The survey took the form of an anonymous questionnaire and sent questionnaires and survey instructions for parents to parents in the form of “homework” arranged by the parent or class teacher. The survey letter briefly described the significance of the survey to children's physical and mental health, and promised teachers and parents free health counseling. Survey items include: 1 General items, including gender, date of birth, date of completion, place of birth; 2DD usage, including whether to use, length of use; 3 toilet training: whether to carry out toilet training, independent completion of defecation age; 4 defecation Dysfunction: Constipation, incontinence, rectal prolapse.
Diagnosis criteria for constipation: Diagnosis Prerequisites 1 Defecation per week ≤ 2 times; 2 At least 1 incontinence per week after you can control defecation; 3 History of defecate retention; 4 History of pain or difficulty in defecation; 5 Large amounts of rectal memory Fecal mass; 6 Huge excrement is enough to block the toilet exit. (Children under 4 years of age) At least 2 of the above symptoms can be diagnosed within 1 month. (Children over 4 years of age) meet ≥ 2 for more than 2 months and have at least 1 episode every week.
Fecal incontinence diagnostic criteria: refers to the inability to control defecation, and the involuntary discharge of rectal contents.
Statistical analysis
SPSS 19.0 statistical software was used for statistical analysis of the data, and measurement data was expressed as `x± s. The χ2 test and the trendχ2 test were compared for the use of DD and the incidence of abnormal defecation between men and women. A t-test was used to compare the age of independent defecation control between DD and non-use DD groups. Take p ≤ 0.05 difference was statistically significant.
Results
1. A total of 6030 questionnaires copies, recycling 5310 copies, 5207(86.35%)questionnaires qualified for the final statistical analysis.
2. A total of 4577 cases using diapers in early childhood (4577/5207, 87.9%); there was no significant difference in the rate of diaperoxide and its duration of use between male and female (p>0.05). 
3. A total of 342 (342/5207,6.6%)cases of defecation dysfunction disorders were diagnosed in 5207 children aged 2to 6 years, 325(325/342)cases using diapers and 17(17/342)without using diapers, the difference between the two groups was statistically significant (p<0.001). 
4. Among the 342 cases of defecation dysfunction disorders, 206 cases of constipation(206/342,60.2%), 93 cases of fecal incontinence(93/342,27.2%), 43 cases of rectal prolapse(43/342,12.6%).
Interpretation of results
1.The defecation reflex of humans includes three types of reflex defecation, conscious defecation and regular defecation. The children transition from neonatal reflex defecation to the free control of defecation in infants and toddlers, and then undergo free control of defecation and transfer to school age. Regular regular defecation, and then to achieve self-controlled defecation, not only related to changes in eating habits, but also rely on the establishment of regular defecation reflex [14]. In this study, the average age of self-defecation without DD group and DD group was: 27.31±9.0 months without DD group and 31.05±9.7 months with DD group, the difference between groups was statistically significant (P<0.05). The results show that toilet training can help children achieve automatic control of defecation earlier, consistent with the above findings.
2.This study showed that the incidence of defecation dysfunction was higher in the DD group than in the non-DD group (p<0.001). Apart from common constipation and contaminated feces, some children showed anal fissure. , Considering the difficulties associated with defecation after long-term constipation, longer duration of defecation and increased abdominal pressure, and rectal and perianal congestion. Mental trauma is a negative effect of defecation dysfunction in children. Especially in children with overflowing stool, involuntary defecation and excessive strained bowel movements cause mental stress, rejection of defecation, inferiority complex and social difficulties, resulting in defecation disorders. The vicious circle eventually aggravates the severity of the original defecation dysfunction and needs to be taken seriously by pediatric surgeons.
Concluding message
In addition, 6.6% of children aged 2 to 6 years still suffer from defecation dysfunction. Children with DD have higher prevalence of defecation dysfunction such as constipation and incontinence. DD can be used as a predictor of defecation dysfunction in preschool children. One of the risk factors for the prevalence rate should cause concern in the society.
Figure 1
Disclosures
Funding National Natural Science Foundation of China(81370869),Sanming Project of Medicine in Shenzhen(SZSM201612013) Clinical Trial No Subjects Human Ethics Committee Zhengzhou University First Affiliated Hospital Ethics Committee Helsinki Yes Informed Consent Yes
28/03/2024 07:12:16