Aerophagia in teenagers: association with child abuse, adverse life events, somatisation and quality of life

Abstract

BACKGROUND: Aerophagia (AP) is characterized by air swallowing, abdominal distension, excessive flatus and belching. Psychological factors are considered as a possible pathophysiological mechanism for AP. We aimed to assess association between aerophagia and exposure to abuse and adverse life events (ALEs), and its effects on somatisation and health related quality of life (HRQoL) in teenagers. METHODS: A cross sectional survey was conducted in 13 to 18 year-olds in 8 randomly selected schools in 4 provinces of Sri Lanka. Translated and validated, self-administered questionnaires were used in data collection. Written parental consent and assent was obtained from all participants. AP was diagnosed using the Rome III criteria. RESULTS: A total of 2453 questionnaires was included in the final analysis (males 1200 [48.9%], mean age 14.8 years, SD 1.6years). Of them, 371 teenagers had AP (15.1%). AP is associated with exposure to physical abuse (20.4% vs. 12.7% in controls), emotional abuse (20.3% vs. 8.2%) and ALEs (22% vs. 10.2%) (p<0,001). ALEs that were associated with AP include, a parent living away from home (20.6% vs. 14.4%), child staying in a hostel (27.1% vs. 14.7%), father’s alcoholism (24.3% vs. 13.4%), and substance abuse (21.8% vs. 14.6%), and quarrels with neighbours (27.7% vs. 13.5%) (p<0.001). Teenagers with AP had higher somatization (16.4 vs 8.9) and lower overall HRQoL (77.0 vs. 85.1) scores than controls (p<0.0001). HRQoL scores were lower in all four domains, namely, physical (80.6 vs. 86.9), emotional (69.1 vs. 80.3), social (83.8 vs 90.5) and school (72.6 vs. 82.5) functioning (p<0.0001). CONCLUSIONS: AP in teenagers is associated with exposure to physical abuse, emotional abuse and ALEs. Affected teenagers have significantly more somatic symptoms. Although considered as benign, AP leads to significant impairment of HRQoL in teenagers