Abstract
Excessive laxity of the connective tissue refers to a group of inherited abnormalities manifested by disturbances in the functioning of internal organs, including the gastrointestinal tract. Increased susceptibility to stretching of the distal part of the large intestine and abnormal colonic motor function could explain the predisposition to the development of functional constipation in some children. Our aim was to determine whether patients with functional constipation are more likely to be characterized by congenital laxity of connective tissue compared to the population of healthy children. Children diagnosed with functional constipation according to the Rome III criteria were prospectively enrolled in the study (study group, S) and compared to otherwise healthy children (control group, C). Excessive laxity of the connective tissue was evaluated using the Beighton Score (BS) and expressed as median and interquartile range (IQR). The study included 411 patients (median age 7.8 years, min 3 years, max 18 years; 49% male), comprising 211 patients in the S group and 200 children in the C group. The median BS in the S group was significantly higher than in the C group (median: 5 points [IQR: 1–4.5] vs 2 points [IQR: 3–7], respectively; p = 0.000). Furthermore, increased connective tissue laxity was observed more frequently in females (p < 0.05). Increased connective tissue laxity was more frequent in children with functional constipation, especially in girls. Excessive laxity of the connective tissue may be one of the etiological factors of functional constipation in children.
Highlights
Excessive laxity of the connective tissue refers to a group of inherited abnormalities manifested by disturbances in the functioning of internal organs, including the gastrointestinal tract
Our study found that children with functional constipation presented significantly more joint hypermobility (JH) relative to otherwise healthy children
The relationship between excessive laxity of connective tissue and disorders of the gastrointestinal tract— including inflammatory bowel diseases, coeliac disease, reflux, dyspepsia, postprandial fullness, complex pain related functional disorders, irritable bowel syndrome, and functional constipation—has been reported in children and a dults[1,3,18,19,20,21,22,23]
Summary
Excessive laxity of the connective tissue refers to a group of inherited abnormalities manifested by disturbances in the functioning of internal organs, including the gastrointestinal tract. Excessive laxity of connective tissue is manifested by an increased range of motion in the joints above the accepted norms and disturbances in the functioning of organs composed of connective tissue[1,2], including the gastrointestinal tract[1,3]. It is well recognized that motor activity of the gastrointestinal tract results from contraction and relaxation of the muscles of the longitudinal and transverse layers. These movements are supported by the tendon-like connective tissue net (TCTN) located between the muscle fibres. In people with JH, the amount of type III collagen compared to type I collagen is higher
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