title: Constipation and Constipation-predominant Irritable Bowel Syndrome: A Comparative Study Using Rome III Criteria.
abstract: The aim of the present study is to compare functional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C) in adolescents.
  
  
  
  A school-based survey was conducted involving adolescents ages 13 to 18 years. A set of validated questionnaires including Rome III questionnaire for functional gastrointestinal disorders in children/adolescents, somatization inventory, quality of life inventory, and childhood traumatic events inventory were used for data collection. FC and IBS-C were defined using Rome III criteria.
  
  
  
  A total of 1792 adolescents (975 boys [45.4%]) were included in the analysis. Prevalence of FC and IBS-C were 7.7% and 1.6%, respectively. Bowel habits such as stool frequency <3 per week (10% vs 44.9%, P < 0.0001), hard stools (20% vs 40.5%, P < 0.05), painful defecation (33.3% vs 56.5%, P < 0.05), large diameter stools (23.3% vs 50.7%, P < 0.01), stool withholding behavior (20% vs 44.2%, P < 0.05), were more commonly associated with FC than did IBS-C. Occurrence of fecal incontinence (0% vs 8%, P = 0.21), urgency (56.7% vs 66.7%, P = 0.65), and straining (56.7% vs 36.9%, P = 0.47) was not significantly different between IBS-C and FC. Exposure to physical abuse, emotional abuse, and sexual abuse was equally prevalent among adolescents with FC and IBS-C. There was no difference between somatization scores, and health-related quality of life between the 2 groups.
  
  
  
  Although bowel habits related to stool withholding are more prevalent in FC, than in IBS-C, they are more likely to be a spectrum of a disorder rather than 2 separate entities.
authors.affiliation: *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.
authors.forename: Shaman
authors.initials: S
authors.lastname: Rajindrajith
authors.forename: Niranga M
authors.initials: NM
authors.lastname: Devanarayana
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
mesh_terms: D000293:Adolescent; D003248:Constipation / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006306:Health Surveys; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index