Prevalence Rates for Constipation and Fecal and Urinary Incontinence Among Pediatric Populations

Abstract

Background: Constipation, fecal incontinence, and urinary incontinence are common in pediatric populations and often coexist, leading to significant physical and psychosocial impacts. Data from South Asia remain limited, particularly regarding age-specific prevalence and associations across developmental stages. Objective: To estimate the prevalence of constipation, fecal incontinence, and urinary incontinence among children and to examine their associations across pediatric age groups. Methods: A cross-sectional study was conducted at a tertiary pediatric hospital in Lahore, Pakistan, between February and December 2022. Children aged 0–17 years were consecutively enrolled, excluding those with congenital anomalies, neurological impairments, or prior incontinence surgery. Data were collected using a validated, structured questionnaire with medical record verification. Constipation was defined using Rome IV criteria; outcomes were analyzed with χ² tests and logistic regression. Results: Of 582 children (mean age 7.6 years), 22.7% had constipation, peaking at 25.7% in ages 2–3 years. Fecal incontinence occurred in 18.3% of children with constipation versus 0.3% without (p<0.001). Urinary incontinence was more frequent in constipated children (21.8% vs. 7.3%, p<0.001), with the strongest association observed for nocturnal symptoms. Conclusion: Constipation is common in South Asian children and is strongly associated with both fecal and urinary incontinence. Integrated screening and early intervention during early childhood may improve outcomes.