Constipation and Constipation-predominant Irritable Bowel Syndrome: A Comparative Study Using Rome III Criteria

Area of Science:

• Pediatric Gastroenterology
• Functional Gastrointestinal Disorders
• Adolescent Health

Background:

• Functional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C) are common functional gastrointestinal disorders in adolescents.
• Differentiating between FC and IBS-C is crucial for appropriate diagnosis and management.
• Adolescent bowel habits and associated factors require further investigation.

Purpose of the Study:

• To compare the clinical characteristics of functional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C) in adolescents.
• To identify differences in bowel habits, psychological factors, and quality of life between FC and IBS-C groups.
• To explore the relationship between FC and IBS-C in an adolescent population.

Main Methods:

• A school-based survey was conducted among 1792 adolescents aged 13-18 years.
• Validated questionnaires, including the Rome III criteria, were used to assess functional gastrointestinal disorders, somatization, quality of life, and childhood traumatic events.
• Prevalence and specific bowel habit differences between FC and IBS-C were analyzed.

Main Results:

• The prevalence of FC was 7.7% and IBS-C was 1.6% in the study population.
• Adolescents with FC reported significantly more stool frequency <3/week, hard stools, painful defecation, large diameter stools, and stool withholding behavior compared to those with IBS-C.
• No significant differences were found in fecal incontinence, urgency, straining, history of abuse, somatization scores, or quality of life between the two groups.

Conclusions:

• While stool withholding behaviors are more prevalent in functional constipation (FC), the findings suggest that FC and constipation-predominant irritable bowel syndrome (IBS-C) may exist on a spectrum rather than being distinct entities in adolescents.
• Further research is warranted to elucidate the precise relationship and shared pathophysiology between FC and IBS-C in this age group.
• These findings have implications for diagnostic criteria and therapeutic approaches for functional bowel disorders in adolescents.