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Journal of Tropical Pediatrics Advance Access published online on August 20, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp077
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Association between Constipation and Stressful Life Events in a Cohort of Sri Lankan Children and Adolescents

Niranga Manjuri Devanarayanaa and Shaman Rajindrajithb

aDepartment of Physiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka 11010
bDepartment of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka 11010

Correspondence: Dr Niranga Manjuri Devanarayana, Department of Physiology, Faculty of Medicine, Talagolla Road, Ragama, Sri Lanka. E-mail: <niranga{at}mfac.kln.ac.lk>.


  Abstract

Emotional stress is associated with some functional gastrointestinal diseases, but its role in aetiology of functional constipation is unclear. This island-wide, questionnaire-based, cross-sectional survey was conducted to assess the association between constipation and emotional stress, in 10–16-year-olds. Constipation was defined using Rome III criteria. Out of 2699 children included in the analysis, 416 (15.4%) had constipation. Constipation was higher in those exposed to stressful events (odds ratio 2.52, p < 0.0001). Separation from the best friend, failure in an examination, severe illness of a family member, loss of job by a parent, frequent punishment by parents and living in an area affected by separatist war remained independently associated with constipation (p < 0.05). In conclusion, constipation was significantly higher in children exposed to stressful life events. Modulation of gut motility through brain–gut axis probably alters colonic transit and ano-rectal functions, causing constipation.

Key Words: emotional stress • functional gastrointestinal disorder • constipation • child • adolescent • war

These two authors contributed equally to this work.


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