Bowel habits of Sri Lankan children and adolescents

Abstract

INTRODUCTION: Bowel habits vary greatly around the world, depending on food consumption and genetic factors. Thorough understanding of normal bowel habits is essential for correct diagnosis of defecation disorders which are common in paediatric age group. Main objective of this study was to evaluate normal bowel habits of Sri Lankan school children. METHOD: Normal children aged 10–16 years, without defecation disorders (e.g. diarrhoea, constipation, irritable bowel syndrome and non-retentive faecal soiling), were randomly selected from 5 schools in 4 districts in Sri Lanka. Details regarding their bowel habits of previous two months were collected using a pre-tested, self administered questionnaire. RESULTS: A total of 2273 children were recruited (male 50%, mean age 13.25 years, SD 1.7 years). Of them 1710 (75%) opened bowels once daily, while 153 (6.7%) and 11 (0.5%) had bowel motions less than 3 per week and more than 3 per day respectively. Stool consistency was normal in 1925 (84.6%), hard in 86 (3.7%), and 163 (7%) had changing consistency. Straining was present in 641 (28%), painful defecation in 273 (10.5%) and bleeding in 49 (2%). One hundred and four (4.6%) children reported stool withholding behaviour. Bulky stool was present in 156 (7%), while faecal soiling was seen in 15 (0.6%). Hard stools, bulky stools, faecal soiling and straining were commoner in males, whereas, painful defecation and withholding behaviour were common among females (p < 0.05). CONCLUSION: Hard stools, bulky stools, faecal soiling and straining were commoner in males, whereas, painful defecation and withholding behaviour were common among females (p < 0.05).