Effect of behavioral therapy on quality of life in children with functional constipation

During childhood, regular defecation in all age groups is considered as a marker of health. Chronic constipation is a source of concern for the family as it may be a sign of serious disease. Functional constipation is considered to develop following intentionally or unintentionally ceasing defecation after an acute precipitating event. In the children, constipation involves psychological and social processes in addition to physical symptoms. A constipated child experiences abdominal pain and pain during defecation as well as he feels himself as unconfident, nervous, unsuccessful in the social environments and relationships with friends, and shy. This is a process affecting quality of life of the child. Basically, the quality of life should be viewed as concept affecting individual satisfaction in adaptation during life conditions and representing individual responses to the physical, mental and social effects of the disease condition on daily life by the individual. Training is of great importance in treatment of constipation during childhood. The treatment becomes effective if the family and child are conceived well and explained that the child doesn?t have a serious disease. Mechanism of incontinence should be explained to the family and the child. They also should be told that the treatment may last for several months. Our aim in the present study was to evaluate effectiveness of behavioral therapy on constipation by measuring quality of life. Our expectation was to see whether quality of life increased with behavioral therapy and to demonstrate it as a measure of behavioral therapy.A total of 129 children were included in the present study. The children in the study group underwent behavioral therapy for constipation. The patients had sociodemographical survey and KINDL quality of life survey adjusted for age groups were applied on the first and third months of the treatment. These surveys were applied as kiddo kindle survey for the age group of 12-16; kid kindle survey for age group of 8-12; kiddy kindle survey for the age group of 4-7; and family form of kindle survey for the children unable to complete the surveys by themselves. The survey for quality of life consisted of such domains as bodily well-being, emotional well-being, self-confidence, family, friends, and school.The constipated children included in the study were divided into groups by their age groups and their quality of life was examined separately at the beginning and end of the treatment. When all age groups were examined collectively, among the quality of life scores at the beginning and first month of the treatment in the children included in the study, statistically significant differences were found in total scores of quality of life, bodily well-being and self-confidence scores (p: 0.000 for all). When quality of life scores were examined at the beginning and the third month of treatment, significant increases were found for all domains (except school domain) (p: 0.000 for domains of bodily well-being, emotional well-being, self-confidence and friends; p: 0.04 for family domain). For the sociodemographical data, statistically significant differences were found for educational status of parents, employment status of parents, number of householders, number of rooms in the house, presence of a special room for the child, income level, and social security as well as some scores of quality of life. However, it was considered that environmental or other factors might have a role in this difference.Results of the present study led us to understand importance of behavioral therapy in functional constipation, that functional constipation impaired quality of life significantly; that administering effectively behavioral therapy in this chronic process increased success of the treatment substantially and demonstrated this effectiveness by improving quality of life. Functional constipation, a chronic condition, should not only be treated with medical treatment but behavioral therapy should also make an important part of the treatment. Functional constipation that affects quality of life of the child as well as his family should be followed in long term and thus, conditions that may occur secondarily should be avoided.Key words: Functional constipation, Quality of life, Behavioral therapy.