Elsevier

The Journal of Pediatrics

Volume 163, Issue 4, October 2013, Pages 1069-1072.e1
The Journal of Pediatrics

Original Article
Quality of Life and Somatic Symptoms in Children with Constipation: A School-Based Study

https://doi.org/10.1016/j.jpeds.2013.05.012Get rights and content

Objective

To assess the health related quality of life (HRQoL) and somatization in school children with constipation.

Study design

This cross-sectional survey was conducted in children aged 13-18 years, in 4 schools in Gampaha district of Sri Lanka. Data were collected using a pretested, self-administered questionnaire with questions on bowel habits, somatization, and HRQoL. Constipation was diagnosed using Rome III criteria.

Results

A total of 1792 children were included in the analysis (males 975 [54.4%], mean age 14.4 and SD 1.3 years). One hundred thirty-eight (7.7%) fulfilled Rome criteria for constipation. Children with constipation had lower HRQoL scores for physical (83.6 vs 91.4 in controls, P < .0001), social (85.0 vs 92.7, P = .0001), emotional (73.6 vs 82.7, P =.0001), school functioning (75.0 vs 82.5, P < .0001), and lower overall scores (79.6 vs 88.0, P = .0001). HRQoL scores were lower in those with fecal incontinence and constipation compared with constipation alone (70.0 vs 81.1, P = .004). Patient perceived severity of abdominal pain (r = −0.22, P = .01) and severity of bowel symptoms (r = −0.22, P = .01) showed significant negative correlation with total HRQoL scores. Total somatization score also found to be negatively correlated (r = −0.47, P < .0001) with HRQoL.

Conclusions

Children with constipation have lower HRQoL scores than controls in physical, social, emotional, and school functioning. They also have a wide range of somatic symptoms. These issues need to be addressed during clinical evaluation of children with constipation to understand the impact of the disease on the life of affected children and to provide optimal care.

Section snippets

Methods

This study was conducted in Gampaha district of Sri Lanka. The district has 501 mixed schools (schools which admit both girls and boys). Of them 166 schools have children with an age range of 13-18 years. We randomly selected 4 schools out of them. From each school all classes from (academic years) 9-12 were selected. All children in these classes who were within the age range of 13-18 years were invited to take part in the study. Ethical approval for the study was obtained from the Ethical

Results

One thousand eight hundred fifty-five questionnaires were distributed and 1792 (96.7%) properly filled questionnaires were included in the analysis. There were 975 (54.4%) males (mean age 14.4 years, SD 1.3). A total of 138 (7.7%) of children had constipation. Constipation was significantly more prevalent in males (9.7% in boys vs 5.2% in girls, P < .0001). Children without constipation were used as controls.

Discussion

Studies assessing HRQoL and somatization in children with chronic constipation are sparse. The main findings of the current study are a significantly lower HRQoL in children with chronic constipation in all 4 main domains (physical, social, emotional, and school functioning); significantly higher somatization scores in affected children, and significant negative correlation between HRQoL and scores obtained for somatization and severity of symptoms.

Two previous studies have assessed the quality

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Funded by the International Foundation for Functional Gastrointestinal Diseases Award (Best Junior Researcher in Paediatrics in 2011 to S.R.). The authors declare no conflicts of interest.

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