Abstract
Objectives: Child abuse leads to multiple physical and psychosomatic sequelae. Aim of this study was to evaluate the association between child abuse and constipation among school children.
Methods: Children aged 13-18 years were selected from four semi-urban schools in Gampaha district, Sri Lanka. A self-administered, questionnaire was used for data collection. Information regarding socio-demographic factors and gastrointestinal symptoms, child abuse and somatisation were collected. Constipation was diagnosed using Rome III criteria.
Results: A total of 1792 children were included in the analysis [males 749 (5 4.9%), mean age 14.4 years, SD 1.3 years]. Hundred and thirty eight (7.7%) fulfilled Rome III criteria for constipation. The number of children exposed to physical, emotional and sexual abuse, were respectively 438 (24.4%), 396 (22.1%) and 51 (2.8%). Prevalence of constipation was significantly higher in those exposed to sexual (5.8% vs. 2.6% p = 0.03), emotional (40.9% vs. 20.8%, p < 0.0001) abuse, and physical abuse (41.6% vs. 23.2%, p < 0.0001). Mean somatisation score was higher in the total group of abused children with constipation (mean 18.6, SD 12.5) compared to those without (mean 13.9, SD 12.3) (p = 0.027). Children with a history of abuse did not seek healthcare more often than children without this history. Patient perceived severity of bowel symptoms were higher in children with physical abuse (23.7 vs. 19.7 p = 0.001) and emotional abuse (25.4 vs. 19.3 p < 0.0001) abuse.
Conclusions: Childhood constipation shows a significant association with physical, sexual and emotional abuse. Children with constipation complain of more somatic symptoms and bowel symptoms when they are exposed to abuse.
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