Bowel patterns, gastrointestinal symptoms, and emotional well-being in adolescents: A cohort study

Author Identifier

Therese O'Sullivan Orcid: https://orcid.org/0000-0003-1003-854X John Olynyk Orcid: https://orcid.org/0000-0003-0417-3411

Document Type

Journal Article

Publication Title

Journal of Gastroenterology and Hepatology




School of Medical and Health Sciences




National Health and Medical Research Council (NHMRC).

Raine Medical Research Foundation.

Further funding information available at: https://doi.org/10.1111/jgh.14699

Grant Number

NHMRC Number : 353514 , NHMRC Number : 403981


Ayonrinde, O. T., Sanfilippo, F. M., O'Sullivan, T. A., Adams, L. A., Ayonrinde, O. A., Robinson, M., ... Olynyk, J. K. (2019). Bowel patterns, gastrointestinal symptoms and emotional well‐being in adolescents–A cohort study. Journal of Gastroenterology and Hepatology, 34(11), 1946-1954. Available here


Background and Aim: Bowel patterns are varied in the general population. Gastrointestinal symptoms are common reasons for clinical visits. We aimed to examine the usual bowel pattern and the prevalence and significance of gastrointestinal symptoms in a population‐based cohort of Australian adolescents. Methods: Seventeen‐year‐old adolescents (n = 1279) in the Western Australian Pregnancy Cohort (Raine) Study participated in a cross‐sectional assessment, involving health questionnaires. Questions included medical history, diet, bowel patterns, and gastrointestinal symptoms. Data were analyzed to identify patterns of bowel motions, gastrointestinal symptoms, and factors associated with these in adolescents. Multivariate logistic regression analysis was used to determine predictors of poorer self‐rated health status. Results: The dominant pattern of bowel motions was passage of stool that was “not too hard and not too soft” (Bristol stool types 3 and 4) in 90% and occurring between three and seven times per week in 74%. The most prevalent gastrointestinal symptoms included abdominal bloating (72%), abdominal pain (36%), nausea (25%), and constipation (20%). A “Western” dietary pattern was associated with abdominal bloating, constipation, and nausea (P < 0.05). Apart from diarrhea, gastrointestinal symptoms were more prevalent in female adolescents than male adolescents (P < 0.05 for all). Female sex (odds ratio [OR] 1.87, 95% confidence interval [CI] 1.16–3.02, P = 0.01), nausea (OR 3.18, 95% CI 2.03–4.98, P < 0.001), and depression (OR 6.68, 95% CI 3.65–12.22, P = 0.03) were independently associated with poorer self‐rated health status, after adjusting for other gastrointestinal symptoms. Conclusions: In adolescents, bowel patterns and gastrointestinal symptoms are diverse and show sex differences. Nausea, depression, and female sex are significant factors for poorer self‐rated health.



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