Okul Çağındaki Çocuklarda Hipermobilite Spektrum Bozuklukları, Fonksiyonel Kabızlık ve İşeme Disfonksiyonu: Birbirleriyle İlişkili midir?

Year 2024, Volume: 11 Issue: 2, 76 - 81, 31.08.2024

Güneş Işık , Elif Sağ , Ferhat Demir , Murat Çakır , Mukaddes Kalyoncu

https://doi.org/10.47572/muskutd.1416077

Abstract

Hipermobilite spektrum bozuklukları, tanısı konmuş sistemik romatolojik bir hastalık olmaksızın kas-iskelet sistemi bulguları ve yaygın eklem hipermobilitesi ile kendini gösterir. Hipermobilite spektrum bozuklukları, disfonksiyonel işeme bozuklukları ve fonksiyonel kabızlık gibi klinik durumlar için risk oluşturabilir. Amacımız okul çağındaki çocuklarda hipermobilite spektrum bozuklukları, işeme disfonksiyonu ve fonksiyonel kabızlık sıklığını saptamak ve birbirleriyle ilişkilerini değerlendirmektir. Bu kesitsel çalışmaya okul çağındaki 947 çocuk (6–15 yaş) dahil edildi. Bir pediatrik romatolog tüm çocukları hipermobilite tanısı koymak için Beighton Hipermobilite Skoru kullanarak muayene etmiş ve fonksiyonel kabızlık tanısı ise bir pediatrik gastroenterolog tarafından konulmuştur. İşeme disfonksiyonu tanısını koymak için bir pediatrik nefrolog tarafından Disfonksiyonel İşeme ve İnkontinans Semptomları Skorlaması kullanılmıştır. İşeme disfonksiyonu genç yaş grubunda, anne eğitim düzeyi düşük olanlarda, gelir düzeyi düşük olanlarda ve idrar yolu enfeksiyonu öyküsü olanlarda daha sık görüldü (sırasıyla p<0.001, p=0.027, p=0.035, p<0.001). İdrar yolu enfeksiyonu öyküsü olan çocuklarda da kabızlık prevalansı daha yüksekti (p=0.001) ve kabızlık görülme sıklığı, işeme disfonksiyonu olan çocuklarda olmayanlara göre belirgin şekilde daha yüksekti (p<0.001). Hipermobilitesi olan ve olmayan çocuklar arasında işeme disfonksiyonu ve kabızlık oluşumu açısından istatistiksel olarak anlamlı bir fark bulunamadı (p>0.05). Hipermobilitesi olan çocuklarda fonksiyonel kabızlık ve işeme disfonksiyonu gibi şikayetlerin arttığı hipotezini doğrulamak için daha fazla çalışmaya ihtiyaç vardır. İşeme disfonksiyonu ve/veya idrar yolu enfeksiyonu olan çocuklarda kabızlık sorgulanmalı ve etkin bir şekilde tedavi edilmelidir.

Keywords

Çocuklar, Fonksiyonel Kabızlık, Hipermobilite Spektrum Bozuklukları, İşeme Disfonksiyonu

Hypermobility Spectrum Disorders, Functional Constipation and Voiding Dysfunction in School-Aged Children: Are They Related to Each Other?

Abstract

Patients suffering from hypermobility spectrum disorders (HSDs) present with problems related to the musculoskeletal system and have generalized joint hypermobility without a diagnosed systemic rheumatological disease. HSDs represent an underlying risk factor for many clinical conditions, such as dysfunctional voiding disorders and functional constipation (FC). In this study, we investigated ways to detect the frequency of HSDs, voiding dysfunction (VD), and FC in school-aged children and assessed their relationship with each other. In this cross-sectional study, 947 school-aged children (6–15 years old) were included. A pediatric rheumatologist examined all children using the Beighton Hypermobility Score to diagnose hypermobility. FC was diagnosed by a pediatric gastroenterologist. The dysfunctional voiding and incontinence symptoms score questionnaire was used by a pediatric nephrologist to diagnose VD. VD was more frequently observed in the younger age group, those whose mothers had lower education levels, children from lower-income families, and those with a history of urinary tract infection (p<0.001, p=0.027, p=0.035, p<0.001, respectively). Children with a history of urinary tract infection also had a higher prevalence of constipation (p=0.001), and the incidence of constipation was significantly higher in children with VD compared to those without VD (p<0.001). The difference in the occurrence of VD and constipation between children with and without hypermobility was not significant (p > 0.05). Further studies are needed to confirm the hypothesis that problems such as FC and VD are worse in children with hypermobility. Constipation should be investigated in children suffering from VD and/or urinary tract infections for effective treatment of these diseases.

Keywords

Children, Functional Constipation, Hypermobility Spectrum Disorders, Voiding Dysfunction

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