Obesity in chronic functional constipation compared to healthy children

Introduction: Childhood obesity and chronic functional constipation (CFC) are common public health problems. This study was designed to compare the prevalence of obesity in children with and without CFC.Materials and Methods: All children referred with constipation (2009-2010) were evaluated, and were enrolled if they were diagnosed as CFC. Children with mild illnesses, but without GI problem, were selected as controls.Their age and sex matched. Data about age, sex, weight, height, body mass index (BMI), duration of breast feeding, duration of constipation, incontinence, daily consumption of fiber and dairy products, daily activity, and family history of CFC were recorded for both groups.Results: 208 constipated children (51% male; mean age: 4.73 yr) and 208 healthy controls were enrolled. 19.7% of patients and 17.8% of controls (P>0.05) were obese (BMI>95%). Patients had: less average (>2 hr) daily activity (80.3% vs. 95.2%; P<0.001); shorter period of breast feeding (16.3 mo. vs. 18.24 mo.; P≈0.017) and more frequently diet with inadequate fiber (58.7% vs. 28.8%; P<0.001). There was no difference for dairy consumption (P≈0/94). Family history of CFC found to be more in patients (28.8% vs. 8.2%; P<0.001). In patient group, mean duration of constipation was longer in obese subjects (in comparison to non-obese ones; 31.4 mo. vs. 21 mo.; P<0.01).Conclusion: Although the prevalence of obesity in children with CFC was similar to healthy age matched population, they were differed by duration of breastfeeding, average daily fiber consumption, average daily physical activity and family history of constipation

Prevalence of celiac disease in siblings of Iranian patients with celiac disease

CONTEXT: Celiac disease, one of the best-known autoimmune human leukocyte antigen-dependent disorders, has a relatively increased prevalence in first-degree relatives. OBJECTIVE: To determine the prevalence of celiac disease in siblings of patients with confirmed celiac disease. METHODS: Siblings of confirmed celiac disease patients in our center were identified and enrolled in this study. Their serum immunoglobulin A and tissue transglutaminase antibody-enzyme-linked immunosorbent assay (anti-tissue transglutaminase, immunoglobulin A, and immunoglobulin G) were measured and multiple endoscopic duodenal biopsy specimens were obtained with parental consensus. Celiac disease was confirmed by observation of characteristic histological changes. RESULTS: A total of 49 children (male, 29; female, 20; age, 2-16 years) with confirmed celiac disease in a pediatric gastroenterology ward were studied from 1999 to 2006. We found 30 siblings (female, 16) all shared in both parents. The only measurement available was for immunoglobulin A tissue transglutaminase antibody. A duodenal biopsy was performed in all 30 siblings. Clinical findings such as abdominal pain, fatigue, growth retardation and diarrhea were found in 53.3% of the completely studied siblings, and positive serology without histological changes was identified in four cases. Both serology and biopsy (confirmed new cases) were positive in 2 of the 30 siblings. CONCLUSION: High prevalence of celiac disease among siblings of patients with confirmed celiac disease necessitates serologic screening (and confirmatory biopsy if indicated) in families having celiac disease. It is advantageous to diagnose the disease as soon as possible because early diagnosis and diet intervention may prevent serious complications such as growth retardation, short stature, chronic diarrhea, and malignancy