Epidemiology of Paediatric constipation in Indonesia and its association with exposure to stressful life events

Background: We aimed to study the epidemiology and risk factors, including exposure to emotional stress, for constipation in Indonesian children and adolescents of 10-17 year age group. Methods: A cross-sectional survey using a validated, self-administered questionnaire was conducted in randomly selected children and adolescents in nine state junior high schools from five districts of Jakarta. All of them were from urban areas. Constipation was defined as a diagnosis by using the Rome III criteria. Results: Of 1796 children included in the analysis, 328 (18.3%; 95% CI 016-0.2) had constipation. Females and those residing in North Jakarta showed risks associated with constipation in school-age children and adolescents. Symptoms independently associated with constipation were abdominal pain (64% vs 43.3% of control) and straining (22.9% vs 6.3%). The prevalence of constipation was significantly higher in those with stressful life events such as father's alcoholism (adjusted OR 1.91, 95% CI 1.27-2.89, P = 0.002), severe illness of a close family member (adjusted OR 1.77, 95% CI 1.12-2.80, P = 0.014), hospitalization of the child for another illness (adjusted OR 1.68, 95% CI 1.22-2.31, P < 0.001), being bullied at school (adjusted OR 1.67, 95% CI 1.01-2.76, P = 0.047) and loss of a parent's job (adjusted OR 1.39, 95% CI 1.03-1.88, P = 0.034). Conclusions: Constipation in children and adolescent is a significant health problem, affecting almost 20% of Indonesian school-age children and adolescents. Common school and home related stressful life events appear to have predisposed these children to develop constipation