Constipation and constipation predominant Irritable Bowel Syndrome: a comparative study using Rome III Criteria

Abstract

OBJECTIVE: The aim of this study is to compare functional constipation (FC) and constipation predominant irritable bowel syndrome (IBS-C) in adolescents. METHOD: A school based survey was conducted involving adolescents aged 13-18 years. A set of validated questionnaires including Rome IIIquestionnaire 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. RESULTS: A total of 1792 adolescents [975 males (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 less than 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 behaviour (20% vs 44.2% p < 0.05), were more commonly associated with FC than IBS-C. Occurrence of faecal 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) were not significantly different between IBS-C and FC. Exposure to physical abuse, emotional abuse, and sexual abuse were equally prevalent among adolescents with FC and IBS-C. There was no difference between somatization scores, and health related quality of life between the two groups. CONCLUSION: Although bowel habits related to stool withholding is more prevalent in FC, than in IBS-C, they are more likely to be a spectrum of a disorder rather than two separate entities