Relationship between psychological stress with functional constipation in children: a systematic review

Introduction: constipation affects up to 29.6% of children worldwide, making it one of the most common gastrointestinal illnesses in the pediatric population. As a functional disorder, the development of constipation is mostly influenced by a child ' s psychosocial condition, even considered as one of important contributing factors. This systematic review aims to evaluate the relationship between psychological stress with constipation in the pediatric population. Methods: three online databases were searched as study sources, including PubMed, the Cochrane Library, and Google Scholar. Study selection was carried out using the PRISMA diagram. Studies that met the eligibility criteria were then included in the data extraction and synthesis. The study quality assessment was done using the Joanna Briggs Institute's (JBI) critical appraisal checklist. Results: eleven studies are included in this systematic review, consisting of four cross sectional studies, four case control studies and three cohort studies. The included studies have good quality based on the assessment. Majority of the studies showed a significant relationship between psychological stress and constipation in children. Psychological stress in children can be classified into family -related stressors, school-related stressors, exposure to stressful life events, stress related to psychological disorders, and other factors. Conclusion: psychological stress and burden are associated to constipation in children. To overcome functional constipation in children, a collaborative effort is required between parents, children, and the healthcare professional.