Do traumatic life events predispose children to develop constipation?

Abstract

BACKGROUND: The aetiology of functional constipation (FC) in children is not been fully understood. Exposure to physical, emotional and sexual abuse are known to predispose children to develop FC. No paediatric study has evaluated traumatic life events other than abuse as a potential predisposing factor for FC in children. We aimed to assess the association between traumatic life events and development of FC in children. METHODS: We conducted a cross sectional, school based study. Children aged 13-18 years were selected from four semi-urban schools in the Gampaha district, Sri Lanka. A validated, self-administered questionnaires were used for collect data on functional gastrointestinal disease and traumatic life events. FC was defined using the Rome III criteria. RESULTS: A total of1792 children were included in the analysis [males 975 (54.4%), mean age 14.4 years, SD 1.3 years years]. Out of them, 138(7.7%) had FC. Prevalence of FC was significantly higher in those exposed to traumatic life events compared to controls (53.6% vs.32.9%,p < 0.0001). Traumatic life events such as parents living separately (13.4% vs. 7.12%,p = 0.038), living in a boarding house (10.1% vs. 1.6%, p = 0.049), liquor abuse by parents (14,8% vs. 6,3%, p < 0.0001), witnessing a murder (16.7% vs. 3.9%, p = 0.002), child labour (13.9%vs. 7.3%, p = 0.02) and ill-treated by parents (27.5% vs. 7.3%, p < 0.0001) were shown to predispose children to develop FC. Parental substance abuse (12.8% vs. 7.4%), domestic violence (14.8 vs. 7.5%) were not associated with FC (p > 0.05). CONCLUSIONS: FC is associated with childhood traumatic experiences. This provides further insight into how traumatic childhood events are associated with development and perpetuation of FC in children.