Citation

Rajindrajith S, Devanarayana NM, Lakmini C, Subasinghe V, de Silva DG, Benninga MA. J. Pediatr. Gastroenterol. Nutr. 2014; 58(4): 486-490.

Affiliation

*Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama, Sri Lanka. 11010 †Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama, Sri Lanka. 11010 ‡Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Centre, Amsterdam, The Netherlands.

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/MPG.0000000000000249

PMID

24253365

Abstract

OBJECTIVES:: Child abuse leads to multiple physical and psychosomatic sequelae. Aim of this study was to evaluate the association between child abuse and constipation among school children.

METHODS:: Children aged 13-18 years were selected from four semi-urban schools in Gampaha district, Sri Lanka. A self-administered, questionnaire was used for data collection. Information regarding socio-demographic factors and gastrointestinal symptoms, child abuse and somatisation were collected. Constipation was diagnosed using Rome III criteria.

RESULTS:: A total of 1792 children were included in the analysis [males 749 (5 4.9%), mean age 14.4 years, SD 1.3 years]. Hundred and thirty eight (7.7%) fulfilled Rome III criteria for constipation. The number of children exposed to physical, emotional and sexual abuse, were respectively 438 (24.4%), 396 (22.1%) and 51 (2.8%). Prevalence of constipation was significantly higher in those exposed to sexual (5.8% vs. 2.6% p = 0.03), emotional (40.9% vs. 20.8%, p < 0.0001) abuse, and physical abuse (41.6% vs. 23.2%, p < 0.0001). Mean somatisation score was higher in the total group of abused children with constipation (mean 18.6, SD 12.5) compared to those without (mean 13.9, SD 12.3) (p = 0.027). Children with a history of abuse did not seek healthcare more often than children without this history. Patient perceived severity of bowel symptoms were higher in children with physical abuse (23.7 vs. 19.7 p = 0.001) and emotional abuse (25.4 vs. 19.3 p < 0.0001) abuse.

CONCLUSIONS:: Childhood constipation shows a significant association with physical, sexual and emotional abuse. Children with constipation complain of more somatic symptoms and bowel symptoms when they are exposed to abuse.

Language: en