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

• Published in: The Journal of pediatrics Vol. 163; no. 4; pp. 1069 - 1072.e1
• Main Authors: Rajindrajith, Shaman, MD, Devanarayana, Niranga Manjuri, DM, Weerasooriya, Lasanthi, MBBS, Hathagoda, Wathsala, MBBS, Benninga, Marc A., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-10-2013
• Subjects: Abdominal Pain; Adolescent; Constipation - diagnosis; Constipation - physiopathology; Cross-Sectional Studies; Fecal Incontinence; Female; Health Status; Humans; Male; Pediatrics; Quality of Life; Schools; Somatoform Disorders - complications; Sri Lanka; Surveys and Questionnaires; Sri Lanka; Health related quality of life; Fecal incontinence; HRQoL; FI
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2013.05.012

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.