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Received May 3, 2017; Revised Aug 24, 2017; Accepted Dec 31, 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
Constipation is one of the most common health problems in children and adults. Variation in the normal bowel habit and symptoms recognized as constipation has made it difficult to accurately diagnose the condition in children. In addition, overflow incontinence and encopresis, both symptoms of functional constipation (FC), are often considered simply as problematic bowel habits and not as symptoms of FC. Therefore, it is difficult to clarify the current state of FC in childhood. The Rome III criteria [1, 2] have been widely applied for the diagnosis of functional gastrointestinal disorders, including FC, and have been commonly used in clinical research. The Rome III criteria include measures of defecation frequency, stool consistency, and other symptoms of FC. However, there are few reports on the prevalence of FC in children in East Asia based on the Rome III diagnostic criteria [3–5].
It is well known that dietary habit can affect defecation, and as such, regional disparity should be considered when determining the prevalence of constipation. Although increasing the intake of dietary fibre and water is often recommended as a dietary therapy for patients with constipation, the influence of total calories and individual nutrients on FC in childhood have not been clarified. A brief-type, self-administered, diet-history questionnaire (BDHQ) developed by Kobayashi et al. has been validated for dietary intake assessment in adults [6]. Asakura et al. revised the BDHQ for use in children aged 3–6 years (BDHQ3y) and then validated the revised questionnaire in Japanese children [7]. This study was aimed at determining the prevalence of FC in Japanese children aged 3–8 years using the Rome III criteria and its relationship with their dietary habits using BDHQ3y.
2. Materials and Methods
2.1. Study Setting and Participants (Figure 1)
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Two types of questionnaire were distributed to the guardians of 2052 children attending 28 public or private nursery schools and 4451 children attending 1st or 2nd grade at 22 public elementary schools (6503 people in all) in Tsurumi Ward, Yokohama...