Treatment of Constipation in Children with Idiopathic Chest Pain and Constipation Could Resolve Their Chest Pain

Background: Chest pain is one of the most frequent causes of a child’s referral to a cardiologist. Objectives: The present study aimed at determining whether treatment of constipation in 4 - 17-year-old children with idiopathic chest pain stops their chest pain. Methods: The current descriptive study was conducted on all patients aged 4 - 17 years old with idiopathic chest pain referring to the Pediatric Cardiology Clinic of Hejazi Hospital, Shiraz, Iran in 2016. A diagnosis of idiopathic chest pain is established after a thorough history taking, physical examination, and appropriate laboratory investigations in patients with no abnormality in the heart, lung, musculoskeletal system, psychological condition, and upper gastrointestinal tract. The study patients were divided into two groups: 36 patients with constipation as cases and 27 patients without constipation as controls. Patients with constipation were supported with toilet training programs and pharmacological treatment. Relief of chest pain was evaluated in the two groups after four months. Results: There were no significant differences in terms of age, gender, weight, and height between the patients with idiopathic chest pain with and without constipation. The number and length of chest pain were significantly different between the case and control groups (P < 0.001 and 0.047, respectively). After medical treatment of constipation, chest pain was significantly stopped in patients with constipation compared with the ones without constipation (P < 0.001). Conclusions: The current study showed that resolution of constipation stopped chest pain in the patients with idiopathic chest pain and constipation. Physicians should consider treatment of constipation as a first modality in each patient with idiopathic chest pain and constipation due to its easy assessment.