Department of Pediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
J Pediatr. 2013 Oct;163(4):1069-72.e1. doi: 10.1016/j.jpeds.2013.05.012. Epub 2013 Jun 22.
To assess the health related quality of life (HRQoL) and somatization in school children with constipation.
This cross-sectional survey was conducted in children aged 13-18 years, in 4 schools in Gampaha district of Sri Lanka. Data were collected using a pretested, self-administered questionnaire with questions on bowel habits, somatization, and HRQoL. Constipation was diagnosed using Rome III criteria.
A total of 1792 children were included in the analysis (males 975 [54.4%], mean age 14.4 and SD 1.3 years). One hundred thirty-eight (7.7%) fulfilled Rome criteria for constipation. Children with constipation had lower HRQoL scores for physical (83.6 vs 91.4 in controls, P < .0001), social (85.0 vs 92.7, P = .0001), emotional (73.6 vs 82.7, P =.0001), school functioning (75.0 vs 82.5, P < .0001), and lower overall scores (79.6 vs 88.0, P = .0001). HRQoL scores were lower in those with fecal incontinence and constipation compared with constipation alone (70.0 vs 81.1, P = .004). Patient perceived severity of abdominal pain (r = -0.22, P = .01) and severity of bowel symptoms (r = -0.22, P = .01) showed significant negative correlation with total HRQoL scores. Total somatization score also found to be negatively correlated (r = -0.47, P < .0001) with HRQoL.
Children with constipation have lower HRQoL scores than controls in physical, social, emotional, and school functioning. They also have a wide range of somatic symptoms. These issues need to be addressed during clinical evaluation of children with constipation to understand the impact of the disease on the life of affected children and to provide optimal care.
评估便秘儿童的健康相关生活质量（HRQoL）和躯体化。
本横断面研究在斯里兰卡甘帕哈区的 4 所学校中进行，纳入年龄为 13-18 岁的儿童。使用经过预测试的自我管理问卷收集数据，问卷中包含有关排便习惯、躯体化和 HRQoL 的问题。便秘采用 Rome III 标准诊断。
共纳入 1792 名儿童进行分析（男性 975 名[54.4%]，平均年龄 14.4 岁，标准差 1.3 岁）。138 名（7.7%）儿童符合 Rome 便秘标准。便秘儿童的身体（对照组为 91.4，便秘组为 83.6，P <.0001）、社会（对照组为 92.7，便秘组为 85.0，P =.0001）、情感（对照组为 82.7，便秘组为 73.6，P =.0001）、学业功能（对照组为 82.5，便秘组为 75.0，P <.0001）和总体评分（对照组为 88.0，便秘组为 79.6，P =.0001）均较低。粪便失禁和便秘儿童的 HRQoL 评分均低于单纯便秘儿童（对照组为 81.1，粪便失禁和便秘组为 70.0，P =.004）。患者感知的腹痛严重程度（r = -0.22，P =.01）和肠道症状严重程度（r = -0.22，P =.01）与总 HRQoL 评分呈显著负相关。总躯体化评分也与 HRQoL 呈负相关（r = -0.47，P <.0001）。
便秘儿童的 HRQoL 评分在身体、社会、情感和学业功能方面均低于对照组。他们也有广泛的躯体症状。在对便秘儿童进行临床评估时，需要考虑这些问题，以了解疾病对受影响儿童生活的影响，并提供最佳护理。
