Factors affecting healthcare consultation in children with chronic constipation: a school based survey

Abstract

INTRODUCTION AND OBJECTIVES: To identify factors determining healthcare consultation in children with chronic constipation. METHODS: An island-wide cross sectional survey was conducted among 10-16 year old children. Five schools were randomly selected from 3 randomly selected provinces of Sri Lanka. From each school, children were randomly selected from academic years (grades) 6-11. Previously validated questionnaire based on Rome III criteria was used in the survey and questions were included about seeking healthcare for constipation. RESULTS: Of the 2770 questionnaires distributed, 2694 (97.3%) properly filled questionnaires were included in the analysis. Four hundred and sixteen (15.4%) children had chronic constipation. Of them, only 16 (3.8%) had sought medical advice for symptoms of constipation during previous 12 months. Healthcare consultation was significantly associated with age less than 12 years, history of constipation among first degree relatives, low stool frequency (less than 3 per week), faeca! -incontinence, stool withholding posture, blood stained stools and presence of vomiting (p<0.05, chi-square test). There was no such association with sex, social class and exposure to emotional stress (p>0.05). CONCLUSIONS: Seeking healthcare for chronic constipation in Sri Lankan children is surprisingly low (3.8%). Children with symptoms of severe constipation such as faecal incontinence are more likely to seek medical help than others. Parents should pay more attention to bowel habits of their children, to identify and treat constipation early, to prevent complications.