The impact of pediatric constipation on appendicitis: a prospective birth cohort in the Japan Environment and Children’s Study

This study aimed to examine the association between constipation and appendicitis in children using data from a nationwide birth cohort, the Japan Environment and Children's Study (JECS). Data were obtained from 64,772 children and their mothers participating in JECS, which included over 100,000 pregnancies across 15 regional centres in Japan. Pediatric constipation was assessed at age three using the Rome III criteria, while appendicitis cases were identified between ages three to four. Logistic regression analyses, including univariable and multivariable models, were conducted to evaluate associations. Additional analyses were stratified by sex. Among the 64,772 children analyzed, 156 cases of appendicitis were identified between the ages of 3 and 4 years. Logistic regression suggested a possible association between constipation and an increased risk of appendicitis (univariable odds ratio [OR]: 1.38, 95% confidence interval [CI]: 0.87–2.10; multivariable OR: 1.36, 95% CI: 0.86–2.06). Although the associations did not reach statistical significance, the point estimates consistently indicated a trend toward increased risk. Although our analyses of children aged 3–4 years did not yield statistically significant associations, the observed trends may suggest a potential link between constipation and appendicitis. These findings should be interpreted only as exploratory, and further studies in different age groups, including older children and adults, are warranted to confirm or refute this possible association.

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Publication Details

Journal
BMC Pediatrics
Published
2025-11-26
DOI
https://doi.org/10.1186/s12887-025-06263-7
Primary Topic
Appendicitis Diagnosis and Management
Type
article
Field-Weighted Citation Impact
0.00

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article

The impact of pediatric constipation on appendicitis: a prospective birth cohort in the Japan Environment and Children’s Study

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BMC Pediatrics
Appendicitis Diagnosis and Management
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The impact of pediatric constipation on appendicitis: a prospective birth cohort in the Japan Environment and Children’s Study

Ryoji Shinohara, Naomi Tamura, Yu Ait Bamai, Hidekuni Inadera, Ryo Kawasaki, Reiko Kishi, Yoshiya Ito, Atsuko Araki, Rahel Mesfin Ketema, Takeo Nakayama, Rieko Yamamoto, Mariko Itoh, Chisato Mori, Maki Tojo, Keitaro Makino, Yasuaki Saijo, Narufumi Suganuma, Shuichi Ito, Seiji Kageyama, Maki Fukami, Michihiro Kamijima, Hiroyoshi Iwata, Yasuhiro Takeshima, Chiharu Ota, Takahiko Katoh, Takeshi Yamaguchi, Shoichi Ohga, Shin Yamazaki, Sachiko Itoh, Koichi Hashimoto
article en

Abstract

This study aimed to examine the association between constipation and appendicitis in children using data from a nationwide birth cohort, the Japan Environment and Children's Study (JECS). Data were obtained from 64,772 children and their mothers participating in JECS, which included over 100,000 pregnancies across 15 regional centres in Japan. Pediatric constipation was assessed at age three using the Rome III criteria, while appendicitis cases were identified between ages three to four. Logistic regression analyses, including univariable and multivariable models, were conducted to evaluate associations. Additional analyses were stratified by sex. Among the 64,772 children analyzed, 156 cases of appendicitis were identified between the ages of 3 and 4 years. Logistic regression suggested a possible association between constipation and an increased risk of appendicitis (univariable odds ratio [OR]: 1.38, 95% confidence interval [CI]: 0.87–2.10; multivariable OR: 1.36, 95% CI: 0.86–2.06). Although the associations did not reach statistical significance, the point estimates consistently indicated a trend toward increased risk. Although our analyses of children aged 3–4 years did not yield statistically significant associations, the observed trends may suggest a potential link between constipation and appendicitis. These findings should be interpreted only as exploratory, and further studies in different age groups, including older children and adults, are warranted to confirm or refute this possible association.

BMC PediatricsVol. 25(1)
Asahikawa Medical College Hospital (JP), Asahikawa Medical University (JP), Hokkaido University (JP), Japanese Red Cross Hokkaido College of Nursing (JP)
Ministry of Environment, Hokkaido University, Nagoya City University
Openalex Percentile: Top 47%
Appendicitis Diagnosis and Management
DOIOpen Access PDFOpenAlex
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