Connective tissue disorder--a new subgroup of boys with slow transit constipation?

J Pediatr Surg. 2008 Jun;43(6):1111-4. doi: 10.1016/j.jpedsurg.2008.02.041.


Purpose: Slow transit constipation (STC) is a form of chronic constipation, with delayed colonic passage of stool. Possible etiologies include reduced neurotransmitter levels, reduced interstitial cells of Cajal density, or a disorder of connective tissue (CT) synthesis. A common CT disorder is generalized joint hypermobility (GJH). This study aimed to investigate whether there was a greater prevalence of GJH among patients with STC than controls.

Methods: Children (aged 7-17) diagnosed with STC by radio/nuclear transit study were recruited from outpatient clinics. Controls (no history of constipation) were recruited from outpatient clinics and a scout jamboree. Hypermobility was assessed using the Beighton score (4 or more = hypermobile). This project received ethical approval by the human research ethics committee.

Results: Thirty-nine STC subjects and 41 controls were measured. Of 39 STC subjects, 15 (38%) were hypermobile, compared to 8 (20%) of 41 controls (P = .06). Analyzed by gender, 10 (38%) of 26 STC males and 1 (4%) of 23 control males were hypermobile (P < .01).

Conclusions: These results show that GJH is higher in STC children, particularly males, suggesting that a disorder of CT synthesis plays a role in the etiology of STC. Further research is required to ascertain the nature of any relationship and how this knowledge may aid our understanding and treatment of STC.

MeSH terms

  • Adolescent
  • Age Distribution
  • Case-Control Studies
  • Child
  • Comorbidity
  • Connective Tissue Diseases / diagnosis
  • Connective Tissue Diseases / epidemiology*
  • Constipation / diagnosis*
  • Constipation / epidemiology*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Motility / physiology*
  • Humans
  • Joint Instability / diagnosis
  • Joint Instability / epidemiology*
  • Male
  • Prevalence
  • Reference Values
  • Risk Assessment
  • Sensitivity and Specificity
  • Sex Distribution