title: Association between constipation and stressful life events in a cohort of Sri Lankan children and adolescents.
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.
authors.affiliation: Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. niranga@mfac.kln.ac.lk
authors.forename: Niranga Manjuri
authors.initials: NM
authors.lastname: Devanarayana
authors.forename: Shaman
authors.initials: S
authors.lastname: Rajindrajith
mesh_terms: D000293:Adolescent; D044466:Asian People; D002648:Child; D003248:Constipation / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D008297:Male; D012307:Risk Factors; D013188:Sri Lanka / Q000453:epidemiology; D013315:Stress, Psychological; D011795:Surveys and Questionnaires