The Relationship of Child Abuse and Functional Constipation in Children: A Case-Control Study

Abstract

Background: Child abuse is a serious global problem and can be in the form of physical, sexual, emotional or neglect by not providing for the child's needs. Functional constipation (FC) is a common functional gastrointestinal (GI) disorder in children. This study was aimed to assess the relationship between child abuse and functional constipation in children. Materials and Methods In this age frequency-matched case-control study, 100 children with FC were compared with 100 healthy children as control. The diagnosis of FC was based on history and physical examination. Child abuse in three sub-groups (physical, emotional and neglect) were assessed by ISPCAN Child Abuse Screening Tool Children's Version (ICAST-C). The data were analyzed by Stata software (version 13.0). Results: The results of this study revealed that the frequency of any kind of child abuse in case (children with functional constipation), and control group (children without functional constipation) is 93% and 84%, respectively, OR: 2.53 (95% CI: 1.00-6.45), P=0.052. The most frequent abuse in both groups was emotional abuse (91% vs. 81%) followed by physical (61% vs. 47%), and neglect (19% vs. 8%). There was a significant association between frequency of emotional (OR: 2.37, P=0.046), physical (OR: 1.76, P=0.048) and neglect abuse (OR: 2.70, P=0.027) among case and control groups. However, after controlling the confounding variables, the association between child abuse and FC remained clinically important but was not statistically significant (P>0.05). Conclusion Notwithstanding emotional abuse, physical abuse and child neglect rate were more frequent among children with FC, this study demonstrates that child abuse is not associated with FC occurrence.