Chronic Constipation Enhances Urinary Tract Infection in Children: Experiences in a Tertiary Care Hospital Outpatient Department

Background: Constipation and urinary tract infection (UTI) are two common pediatric problems. Chronic constipation is thought to enhance the occurrence of childhood UTI. So, prevention and treatment of constipation will reduce UTI and its complications such as renal scarring, hypertension and chronic renal failure. This study was conducted to find out the impact of chronic constipation on UTI in children. Methods: This case-control study was done from August 2017 to December 2019 in the general pediatrics and pediatric surgery outpatient department (OPD) of a tertiary care children’s hospital in Dhaka, Bangladesh. It was conducted on 164 children aged 1-15 years of which 82 constipated children who met Rome III criteria for chronic constipation were taken as case group and 82 non-constipated children as control group. Children having congenital urinary or anorectal anomalies detected by clinical examination and urogenital ultrasonogram (USG) were excluded from the study. Urine routine microscopic examination (RME) and culture-sensitivity (CS) were done for all patients. Growth of a single species of organism with colony count of >105/ml or colony counts 104/ml with pyuria (pus cells >5/HPF) in the symptomatic child was considered as UTI. Results: UTI was detected in 27 (32.9%) constipated children and in 9 (10.9%) non-constipated children (p=0.0007). Within one month after proper treatment, 29 children underwent voiding cystourethrogram (VCUG); 24 in case group and 5 in control group. VUR was found in total 10 (34.5%) children; 9 (37.5%) in case group and 1 (20%) in control group (p=0.45). Conclusion: Chronic constipation has significant impact on occurrence of UTI in children. So early and effective preventive measures and treatment for constipation will be useful to reduce occurrence of UT