Empirically Derived Patterns of Pain, Stooling, and Incontinence and Their Relations to Health-Related Quality of Life Among Youth With Chronic Constipation

J Pediatr Psychol. 2017 Apr 1;42(3):325-334. doi: 10.1093/jpepsy/jsw068.


Objective: Chronic constipation is associated with pain, stress, and fecal incontinence, which negatively impact health-related quality of life (HRQoL); however, it is unclear if patterns of pain, stool frequency, and incontinence are differentially associated with HRQoL in youth with chronic constipation.

Methods: 410 caregivers completed a demographics and symptoms form, the Parental Opinions of Pediatric Constipation, Pediatric Symptom Checklist, and the Functional Disability Inventory.

Results: Stooling patterns were derived using Latent Variable Mixture Modeling. A three-class model emerged: withholding/avoiding ( WA ), pain , and fecal incontinence ( FI ). The pain class reported the greatest amount of disease burden/distress, greatest impairments in illness-related activity limitations, more psychosocial problems, and, along with the FI class, elevated levels of family conflict. The FI class reported the greatest amount of parental worry of social impact.

Conclusions: Youth with chronic constipation who experience pain or fecal incontinence may be at a greater risk for specific HRQoL problems such as illness-related activity limitations, psychosocial issues, disease burden and worry, and family conflict.

Keywords: elimination disorders; gastroenterology; pain; quality of life.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Caregivers / psychology
  • Child
  • Child, Preschool
  • Chronic Disease
  • Constipation / complications*
  • Constipation / psychology*
  • Family Conflict / psychology
  • Fecal Incontinence / complications*
  • Fecal Incontinence / psychology
  • Female
  • Humans
  • Male
  • Pain / complications*
  • Pain / psychology
  • Parents / psychology
  • Quality of Life / psychology*
  • Surveys and Questionnaires