Fecal Incontinence in Adolescents Is Associated With Child Abuse, Somatization, and Poor Health-related Quality of Life.
The aim of this study was to evaluate the association between fecal incontinence (FI), child abuse, somatization, and health-related quality of life (HRQoL) in adolescents.



Adolescents (ages 13-18 years) were selected from 4 semi-urban schools in the Gampaha district, Sri Lanka. A validated, self-administered questionnaire was used for data collection. FI was defined as at least 1 episode of leakage of feces per month.



A total of 1807 adolescents were analyzed (boys 973 [53.8%], mean age 14.4 years, standard deviation [SD] 1.4 years). A total of 47 (2.6%) had FI. Prevalence of sexual abuse (17% vs 2.3% in controls, P < 0.0001), emotional abuse (40.4% vs 22.7%, P < 0.0001), and physical abuse (51% vs 24.3%, P < 0.0001) was significantly higher in children with FI. Adolescents with FI had higher mean somatization scores [mean 20.1, (SD 14.5) vs mean 9.3, (SD 9.2)] compared with those without FI (P < 0.0001). Those with FI also had lower HRQoL scores for physical functioning, social functioning, emotional functioning domains, and performances at school, together with a lower overall HRQoL score compared with those without FI (74.6 vs 87.1, P < 0.0001).



There is a significant association between FI and physical, sexual, and emotional abuse. They also have a higher somatization score and a poor HRQoL score in physical, emotional, social, and school functioning domains compared with those without FI.
*Department of Paediatrics †Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka ‡Department of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Centre, Amsterdam, The Netherlands.
Shaman
S
Rajindrajith
Niranga Manjuri
NM
Devanarayana
Marc Alexander
MA
Benninga
D000293:Adolescent; D000067697:Adolescent Health; D002649:Child Abuse / Q000523:psychology*; D005242:Fecal Incontinence / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics; D011788:Quality of Life; D013001:Somatoform Disorders / Q000523:psychology*; D013188:Sri Lanka; D011795:Surveys and Questionnaires