Relationship of Functional Constipation and Growth Status: A Systematic Review and Meta-Analysis

Objectives: Functional constipation (FC) and malnutrition are 2 of the most common diseases affecting children worldwide with long-term consequences. We hereby performed a systematic review and meta-analysis to analyze the relationship between these 2 entities. Methods: We searched PubMed, American Academics of Pediatrics (AAP), Cochrane, ClinicalTrials.gov (from inception to December 11, 2021) using "constipation,""growth," and "children" as the keywords. Newcastle-Ottawa Scale was used as the risk of bias assessment tool. Meta-analysis using the random-effects model was done. Results: Eighteen studies involving 33,410 children were chosen in this study. Meta-analysis of all the studies showed statistically significant relationship between FC with both overweight/obesity [odds ratio (OR) = 1.75; 95% confidence interval (CI) = 1.11-2.76; P= 0.02], in Asian countries subgroup, and undernutrition (OR = 2.38; 95% CI = 1.43-3.97; P< 0.001) in Asian countries using ROME criteria's subgroup. Normal weight patients were also more prevalent in non-FC patients in Asia (OR = 0.54; 95% CI = 0.38-0.76; P < 0.001). The relationship between FC and short stature is still inconclusive. Conclusions: FC is correlated with the prevalence of both overweight/obesity and undernutrition. Future studies should evaluate the causal relationship and whether FC treatment could help.