Obez Çocuk ve Ergenlerde Mesane Bağırsak Disfonksiyonu ve Yaşam Kalitesi

Öz

Giriş: Obezite, çocuk ve ergenlerde sıklığı giderek artan ciddi bir sağlık sorunu (MBD) da yol açabilmektedir. Hem obezitenin hem de MBD’nin yaşam kalitesine olumsuz etkiler yaptığı bilinmektedir. Bu çalışmada, obez çocuk ve ergenlerde eşlik eden MBD’nin yaşam kalitesine etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmaya, Nisan 2019 - Aralık 2019 tarihleri arasında, üçüncü basamak hastane çocuk sağlığı ve hastalıkları polkliniklerine başvuran 5-17 yaş arası obez çocuk ve adolesanlar alındı. Diğer gruplara benzer yaş ve cinsiyette normal kilolu, solunum yolu enfeksiyonu için kontrole gelen ve Çocuk Nefrolojisi polikliniğine mesane barsak disfonksiyonu bulguları ile başvuran olgular alındı. Mesane Bağırsak Semptom Skorlamasına (MBSS) göre 11 ve üzeri puan alan olgular MBD olarak değerlendirildi. Tüm olgulara, Çocuklar için Yaşam Kalitesi Ölçeği (ÇİYKO) uygulandı. Bulgular: Çalışmaya yaş ortalaması 11,7±3,1 olan 148 obez ve 141 normal kilolu olmak üzere toplam 289 olgu alındı. Obez grupta yaşam kalitesi alt ölçek ve toplam skorları normal ağırlıktaki kontrol grubuna göre anlamlı düşüktü. ÇİYKO’da obez olguları MBSS’ye göre ikiye ayırarak karşılaştırma yaptığımızda, MBSS≥11 olan grupta yaşam kalitesi alt ölçek ve toplam skorları istatistiksel olarak anlamlı derecede düşük idi. (p<0,001). MBSS≥11 olan olgulardan obez olanlarda FSTP ve ÖTP’de istatistiksel olarak anlamlı fark saptandı. Sonuç: Bu çalışmada, gerek obezite gerekse MBD’nin yaşam kalitesi üzerine olan olumsuz etkileri ortaya konulurken MBD’nin yaşam kalitesini daha da olumsuz etkilediğini, her ikisinin birbiri ile komorbid durumlar olduğu ve hem MBD’nin hem de obezitenin birlikte olduğu durumlarda ise yaşam kalitesinin en çok etkilendiği sonucuna varıldı.

Anahtar Kelimeler

• Obezite,
• mesane bağırsak disfonksiyonu,
• mesane bağırsak skoru,

Bladder Bowel Dysfunction and Quality of Life in Obese Children and Adolescents

Öz

Introduction: Obesity has become a serious health problem with increasing frequency in children and adolescents. Besides metabolic problems, it can also cause bladder-bowel dysfunction (BBD). It is known that both obesity and BBD have negative effects on the quality of life. In this study, we aimed to investigate the effect of BBD on the quality of life in obese children and adolescents. Materials and Methods: Obese children and adolescents aged 5 to 17 years who were admitted to pediatric outpatient clinics between April 2019 and December 2019 were included in the study. The cases with normal weight, similar age and sex to the other groups, who came for respiratory tract infection and presented to the Pediatric Nephrology outpatient clinic with signs of bladder-bowel dysfunction were included. The cases who scored 11 or above according to the Bladder Bowel Symptom Score (BBSS) were considered as BBD. Results: A total of 289 patients, 148 obese and 141 normal weight, with a mean age of 11.7±3.1 years were included in the study. In the obese group, the quality of life subscale and total scores were significantly lower than the control group with normal weight. In obese cases, the quality of life subscale and total scores were significantly lower in the group with BBSS≥11 (p<0.001). There was a statistically significant difference in the physical health total score and the total scale score in the obese patients with BBSS≥11. Conclusions: In this study, while the negative effects of both obesity and BBD on the quality of life were revealed, it was seen that BBD affects the quality of life even more negatively, and both of them are comorbid situations with each other. In addition, it was concluded that the quality of life is most affected when both MBD and obesity coexist.

Kaynakça

1. 1. Murray C, Pilling D, Shaw N. Persistent acquired lobar overinflation complicating bronchopulmonary dysplasia. European journal of pediatrics. 2000;159(1-2):14-7.
2. 2. Erermis S, Cetin N, Tamar M, Bukusoglu N, Akdeniz F, Goksen D. Is obesity a risk factor for psychopathology among adolescents? Pediatrics International. 2004; 46(3):296-301.
3. 3. Buttitta M, Iliescu C, Rousseau A, Guerrien A. Quality of life in overweight and obese children and adolescents: a literature review. Quality of life research. 2014;23(4):1117-39.
4. 4. Fishman L, Lenders C, Fortunato C, Noonan C, Nurko S. Increased prevalence of constipation and fecal soiling in a population of obese children. The Journal of pediatrics. 2004;145(2):253-4.
5. 5. Oliver JL, Campigotto MJ, Coplen DE, Traxel EJ, Austin PF. Psychosocial comorbidities and obesity are associated with lower urinary tract symptoms in children with voiding dysfunction. The Journal of urology. 2013;190(4S):1511-5.
6. 6. Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. Jama. 2003;289(14):1813-9.
7. 7. Borzekowski D, Bayer AM. Body image and media use among adolescents. Adolesc Med Clin. 2005;16(2):289-313.
8. 8. Dallar Y, Erdeve ŞS, Çakır İ, Köstü M. Obezite, çocuklarda depresyon ve özgüven eksikliğine neden oluyor mu. Gülhane Tıp Dergisi. 2006;48(1):1-3.

9. 9. Strauss CC, Smith K, Frame C, Forehand R. Personal and interpersonal characteristics associated with childhood obesity. Journal of Pediatric Psychology. 1985;10(3):337-43.
10. 10. Sureshkumar P, Jones M, Cumming R, Craig J. A population based study of 2,856 school-age children with urinary incontinence. The Journal of urology 2009;181(2):808-16.
11. 11. Bulum B, Özçakar ZB, Kavaz A, Hüseynova M, Ekim M, Yalçınkaya F. Lower urinary tract dysfunction is frequently seen in urinary tract infections in children and is often associated with reduced quality of life. Acta Paediatrica. 2014;103(10):454-8.
12. 12. Neyzi O, Günöz H, Furman A, Bundak R, Gökçay G, Darendeliler F. Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri. Çocuk Sağlığı ve Hastalıkları Dergisi. 2008;51(1):1-14.
13. 13. Drzewiecki BA, Thomas JC, Pope JC, Adams MC, Brock JW, Tanaka ST. Use of validated bladder/bowel dysfunction questionnaire in the clinical pediatric urology setting. The Journal of urology. 2012;188(4S):1578-83.
14. 14. Narter FK, Tarhan F, Narter KF, Sabuncu K, Eser RA, Akin Y, et al. Reliability and validity of the Bladder and Bowel Dysfunction Questionnaireamong Turkish children. Turkish journal of medical sciences. 2017;47(6):1765-9.
15. 15. Varni JW, Seid M, Rode CA. The PedsQL™: Measurement model for the pediatric quality of life inventory. Medical care. 1999:37(2):126-39.
16. 16. Memik NÇ, Ağaoğlu B, Coşkun A, Üneri ÖŞ, Karakaya I. Çocuklar için yaşam kalitesi ölçeğinin 13-18 yaş ergen formunun geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi. 2007;18(4):353- 63.
17. 17. Çuhadaroğlu F. Adölesanlarda Benlik Saygısı. İzmir Dr. Behçet Uz Çocuk Hast. Dergisi. 2018;8(1):51-58.
18. 18. Yeung CK, Sreedhar B, Leung YFV, Sit KYF. Correlation between ultrasonographic bladder measurements and urodynamic findings in children with recurrent urinary tract infection. BJU international. 2007;99(3):651-5.
19. 19. Tikkinen KA, Auvinen A, Huhtala H, Tammela TL. Nocturia and obesity: a population-based study in Finland. American journal of epidemiology. 2006;163(11):1003-11.
20. 20. Swallen KC, Reither EN, Haas SA, Meier AM. Overweight, obesity, and health-related quality of life among adolescents: The National Longitudinal Study of Adolescent Health. Pediatrics. 2005;115(2):340-7.
21. 21. Joinson C, Heron J, von Gontard A. Psychological problems in children with daytime wetting. Pediatrics. 2006;118(5):1985-93.
22. 22. Perez J. Early intervention for childhood continence problems. Community Practitioner. 2014;87(7):44-7.
23. 23. Ferguson CJ, Kilburn J. The public health risks of media violence: A meta-analytic review. The Journal of Pediatrics. 2009;154(5):759-63.
24. 24. Chang S-J, Yang SS. Inter-observer and intra-observer agreement on interpretation of uroflowmetry curves of kindergarten children. Journal of Pediatric Urology. 2008;4(6):422-7.
25. 25. Barone JG, Hanson C, DaJusta DG, Gioia K, England SJ, Schneider D. Nocturnal enuresis and overweight are associated with obstructive sleep apnea. Pediatrics. 2009;124(1):53-9.
26. 26. Cummings J, Rodning C. Urinary stress incontinence among obese women: review of pathophysiology therapy. International Urogynecology Journal. 2000;11(1):41-4.
27. 27. Fraga L, Sampaio A, Boa-Sorte N, Veiga M, Braga ANM, Barroso U. Obesity and lower urinary tract dysfunction in children and adolescents: Further research into new relationships. Journal of pediatric urology. 2017;13(4):387.
28. 28. Weintraub Y, Singer S, Alexander D, Hacham S, Menuchin G, Lubetzky R, et al. Enuresis—an unattended comorbidity of childhood obesity. International Journal of Obesity. 2013;37(1):75-8.