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Constipation in children: an epidemiological study in Sri Lanka using Rome III criteria
  1. Shaman Rajindrajith1,
  2. Niranga Manjuri Devanarayana2,
  3. Chandralatha Adhikari1,
  4. Waruni Pannala1,
  5. Marc A Benninga3
  1. 1Department of Paediatrics, University of Kelaniya, Ragama, Sri Lanka
  2. 2Department of Physiology, University of Kelaniya, Ragama, Sri Lanka
  3. 3Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Dr Shaman Rajindrajith, Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Talagolla Road, Ragama 11010, Sri Lanka; rajindrajith{at}


Constipation is a common paediatric problem, but its prevalence in Asia is unknown. A cross-sectional survey using a previously validated, self-administered questionnaire was conducted in randomly selected children aged 10–16 years, in five randomly selected schools in Sri Lanka. Two schools were in Eastern Province, which has been affected by the separatist war. Constipation was defined using Rome III criteria. Of 2694 children included in the analysis, 416 (15.4%) had constipation. Symptoms independently associated with constipation were straining (71.6% vs 28.4% of controls), bleeding per rectum (14.2% vs 2.2%) and abdominal pain (55% vs 35.2%). The prevalence of constipation was significantly higher in those with a family history of constipation (49% vs 14.8%), living in a war affected area (18.1% vs 13.7%) and attending an urban school (16.7% vs 13.3%). In conclusion, chronic constipation is a significant problem affecting 15% of Sri Lankan school children and adolescents.

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  • Competing interests None.

  • Patient consent Parental consent obtained.

  • Ethics approval This study was conducted with the approval of the Ethics Review Committee of the Sri Lanka College of Paediatricians.

  • Provenance and peer review Not commissioned; externally peer reviewed.