title: Medical presentation of constipation from childhood to early adulthood: a population-based cohort study.
abstract: OBJECTIVE
  Constipation is a common disorder in children and adults, but the role of gender and early life risk factors remains undefined. The aims of the study were as follows: (1) to estimate the incidence of medical presentation for constipation in a population-based birth cohort, and (2) to examine factors associated with constipation presentation from childhood to adulthood.
  
  
  METHODS
  A birth cohort of all children born between 1976 and 1982 to mothers who were residents of Rochester, Minnesota, and who remained in the community until age 5 was used for this study. Medical visits for constipation were identified by diagnoses codes and chart review. Subjects were followed up based on their diagnoses accumulated while younger than 21 years old, and 80% of subjects remained in the area until 18 years of age.
  
  
  RESULTS
  Of 5299 birth cohort members without constipation presentation before age 5, the overall age- and sex-adjusted incidence was 3.9 per 1000 person-years. A higher incidence for constipation in females occurred beginning at 13 years to early adulthood (rate ratio, 2.6 for 13-16 y and 4.2 for 17 to <21 y). Children with a diagnosis for constipation at younger than 5 years of age had a significantly higher incidence for subsequent medical visits for constipation through adolescence and early adulthood compared with the incidence rate of children without an early medical presentation (rate ratio, 4.5 for 5-8 y, 2.5 for 9-12 y, and 3.9 for 17-20 y).
  
  
  CONCLUSIONS
  Early medical presentation and female sex influence incident and repeat medical visits for constipation from childhood to early adulthood.
authors.affiliation: University of North Carolina Center for Functional GI and Motility Disorders, Division of Pediatric Gastroenterology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
authors.forename: Denesh K
authors.initials: DK
authors.lastname: Chitkara
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.forename: G Richard
authors.initials: GR
authors.lastname: Locke
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.forename: Slavica K
authors.initials: SK
authors.lastname: Katusic
authors.forename: Heiko
authors.initials: H
authors.lastname: De Schepper
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Rucker
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009819:Office Visits / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors