BMJ Open 1:e000237 doi:10.1136/bmjopen-2011-000237
  • Epidemiology
    • Research

Is there an association between wheezing and constipation in preschool children? Explanations from a longitudinal birth cohort

  1. H A Moll2
  1. 1The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands
  2. 2Department of Paediatrics, Erasmus Medical Centre, Rotterdam, The Netherlands
  3. 3Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
  4. 4Department of Paediatrics/Respiratory Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
  1. Correspondence to Professor Henriëtte A Moll; h.a.moll{at}
  • Received 27 June 2011
  • Accepted 8 August 2011
  • Published 30 September 2011


Objective To assess whether wheezing and atopic dermatitis were associated with constipation in preschool children and to what extent shared risk factors contribute to this relationship.

Methods A population-based sample of 4651 preschool children was used. At the age of 24, 36 and 48 months, a parental report of functional constipation was available according to the Rome II criteria, and data on atopic dermatitis and wheezing were available using age-adapted questionnaires from the International Study of Asthma and Allergies in Childhood. Stepwise multivariate analyses were performed to assess whether body mass index, infection exposure, food allergy and infant nutrition, and parental stress explained the association between wheezing, atopic dermatitis and constipation.

Results Out of 4651 children, 12–17% had functional constipation between 24 and 48 months. Symptoms of wheezing decreased from 20% to 12% and atopic dermatitis decreased from 30% to 18% at the age of 24 and 48 months respectively. Between the age of 24 and 48 months, wheezing symptoms were significantly associated with functional constipation (OR 1.17; 1.02 to 1.34) but these results were mainly explained by the child's exposure to infections and use of antibiotics (adjusted odds ratio 1.08; 95% CI 0.95 to 1.24). No significant association was found between symptoms of atopic dermatitis and functional constipation (OR 1.08; 95% CI 0.94 to 1.23).

Conclusions These findings suggest that functional constipation coexists with wheezing in childhood but is mainly explained by the child's infection exposure and use of antibiotics. Therefore, an independent association between respiratory symptoms and functional bowel disorders as suggested in previous studies is questionable.


  • Correction notice The “To cite: …” information and running footer in this article have been updated with the correct volume number (volume 1).

  • To cite: Kiefte-de Jong JC, Lebon A, Jaddoe VWV, et al. Is there an association between wheezing and constipation in preschool children? Explanations from a longitudinal birth cohort. BMJ Open 2011;1:e000237. doi:10.1136/bmjopen-2011-000237

  • Funding Erasmus Medical Centre, the Erasmus University Rotterdam, the Netherlands Organization for Health Research and Development (Zon Mw) and Europe Container terminals.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Medical Ethical Committee of the Erasmus Medical Centre, Rotterdam, The Netherlands.

  • Contributors Involvement in the design, planning, conducting the study and data collection: HAM, VWVJ, AH, JCdJ, JCK-dJ. Statistical analyses and interpreting data: JCK-dJ, HAM, AL. Drafting the final manuscript: JCK-dJ, HAM. All authors critically reviewed the manuscript and approved the final version of the manuscript to be published.

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

  • Data sharing statement No additional data available.

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