Functional gastrointestinal disorders and nutritional status in junior high school students

  • Fatima Safira Alatas Faculty of Medicine, Universitas Indonesia, Department of Child Health, Cipto Mangunkusumo Hospital
  • Khansa Salsabila
  • Nadira -
  • Nasya Amalia
  • Gryselda Hanafi
Keywords: functional gastrointestinal disorder, functional constipation, functional dyspepsia, irritable bowel syndrome, nutritional status


Background The prevalence of functional gastrointestinal disorders (FGIDs) is increasing among students in Indonesia. More adolescents came to the clinic with symptoms of functional constipation (FC), irritable bowel syndrome (IBS), and functional dyspepsia (FD).

Objective To analyze the relationship between the nutritional status, dietary pattern, and physical activity with the incidence of the FGIDs among Indonesian junior high school students.

Methods A cross-sectional study, consisting of 292 students aged 11 to 14 years were recruited in March 2018. Questionnaires on the ROME Criteria for FGIDs, dietary patterns, and physical activity were distributed to the students’ parents and returned in 24 hours.

Results The overall prevalence of FGIDs in this study was 26.4%. Among 292 junior high school students, 19.5% were diagnosed with FC, 6.2% with IBS, and 17.5% with FD. Overnourishment (overweight or obese) was found in 51.4% of the subjects. A significant association was found between FC and overnutrition (OR 2.27; 95%CI 1.21 to 4.28; P=0.011). Nutritional status did not affect the incidence of IBS nor FD. Rarely eating breakfast significantly increase the occurrence of FD (OR 4.80; 95%CI 1.61 to 13.25; P=0.004). No significant association between dietary patterns and physical activity with the prevalence of the other FGIDs.

Conclusion Nutritional status does not significantly affect the prevalence of IBS and FD. Overnourishment is associated with increased occurrence of FC. Eating breakfast twice weekly or more may reduce the probability of FD. Lack of healthy dietary pattern and physical activity are not correlated with other FGIDs.


1 Lacy BE, Patel NK. Rome criteria and a diagnostic approach to irritable bowel syndrome. J Clin Med. 2017;6:99. DOI:
2 Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006;130:1377-90. DOI:
3 Longo D, Fauci A. Harrison’s gastroenterology and hepatology. New York: McGraw-Hill; 2010. p.54.
4 Putri WH, Jurnalis DY, Edison. Hubungan status gizi dengan kejadian konstipasi pada siswa SD di kecamatan Padang Barat, Sumatera Barat, Indonesia. CDK. 2015;42:807. DOI:
5 Levy EI, Lemmens R, Vandenplas Y, Devreker T. Functional constipation in children: challenges and solutions. Pediatric Health Med Ther. 2017;8:19-27. DOI:
6 Kiefte-de Jong JC, de Vries JH, Escher JC, Jaddoe VW, Hofman A, Raat H, et al. Role of dietary patterns, sedentary behaviour and overweight on the longitudinal development of childhood constipation: the Generation R study. Matern Child Nutr. 2013;9:511-23. DOI:
7 Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. J Family Med Prim Care. 2015;4:187-92. DOI:
8 Ford AC, Talley NJ. Irritable bowel syndrome. BMJ. 2012;345:e5836. DOI:
9 Fillekes L, Prayogo A, Alatas FS, Hegar B. Irritable bowel syndrome and its associated factors in adolescents. Paediatr Indones. 2014;54:344-50. DOI:
10 Pickett-Blakely O. Obesity and irritable bowel syndrome: a comprehensive review. Gastroenterol Hepatol (NY). 2014;10:411-16. PMID: 25904828.
11 Mayer EA. Functional gastrointestinal disorders: irritable bowel syndrome, dyspepsia, chest pain of presumed esophageal origin, and heart burn. In: Goldman L, Schafer AI, editor. Goldman Cecil Medicine. Philadelphia: Goldman-Cecil Medicine; 2016. p.852-6.
12 Moray G, Tezcaner T, Akdur A, Özçay F, Sezgin A, K?rnap M, et al. Results of pediatric liver transplant: A single-center experience. Exp Clin Transplant. 2015;13:59-63. PMID: 25894129.
13 Simadibrata M, Abdullah M, Syam AF, Fauzi A, Makmun D, Manan C, et al. Dyspeptic syndrome in urban population in Jakarta. Ina JGHE. 2010;10:66-70. DOI:
14 Ho W, Spiegel BMR. The relationship between obesity and functional gastrointestinal disorders: causation, association, or neither? Gastroenterol Hepatol (NY). 2008;4:572-78. PMID: 21960939.
15 Suarez K, Mayer C, Ehlert U, Nater UM. Psychological stress and self-reported functional gastrointestinal disorders. J Nerv Ment Dis. 2010;198:226-29. DOI:
16 Waterlow JC. Classification and definition of protein-calorie malnutrition. Br Med J. 1972;3:566-69. DOI:
17 Walker LS, Caplan A, Rasquin A. Rome III diagnostic questionnaire for the pediatric functional GI disorders [Internet]. [cited 2018 Jul 5]. Available from:
18 Intan NR. Faktor-faktor yang berhubungan dengan obesitas berdasarkan persen lemak tubuh pada remaja di SMA Islam terpadu. Fakultas Kesehatan Masyarakat Universitas Indonesia [Internet]. [cited 2018 Jul 7]. Available from:
19 Perkumpulan Gastroenterologi Indonesia (PGI). Syam AF, Aulia C, Makmun D, Renaldi K, Simadibrata M, Abdullah M, et al., editors. Konsensus penatalaksanaan irritable bowel syndrome di Indonesia. Jakarta: PGI; 2013. p.3.
20 Spiroglou K, Paroutoglou G, Nikolaides N, Xinias I, Giouleme O, Arsos G, et al. Dyspepsia in childhood. Clinical manifestations and management. Ann Gastroenterol. 2004;17:173-80.
21 Nasution BB. Hubungan status gizi dengan kejadian konstipasi fungsional pada anak. [cited 2018 Jul 7]. Available from:
22 Fishman L, Lenders C, Fortunato C, Noonan C, Nurko S. Increased prevalence of constipation and fecal soiling in a population of obese children. J Pediatr. 2004;145:253-4. DOI:
23 Teitelbaum JE, Sinha P, Micale M, Yeung S, Jaeger J. Obesity is related to multiple functional abdominal diseases. J Pediatr. 2009;154:444-6. DOI:
24 Bonilla S, Wang D, Saps M. Obesity predicts persistence of pain in children with functional gastrointestinal disorders. Int J Obes (Lond). 2011;35:517-21. DOI:
25 Childs AA, John RM. Pooping shouldn’t be this hard: using nutrition to address constipation in primary care. Infant Child Adolesc Nutr. 2015;7:287-302. DOI:
26 Sujatha B, Velayutham DR, Deivamani N, Bavanandam S. Normal bowel pattern in children and dietary and other precipitating factors in functional constipation. J Clin Diagnostic Res. 2015;9:SC12–5. DOI:
27 El-Salhy M, Ystad SO, Mazzawi T, Gundersen D. Dietary fiber in irritable bowel syndrome. Int J Mol Med. 2017;40:607-13. DOI:
28 Xu JH, Lai Y, Zhuang LP, Huang CZ, Li CQ, Chen QK, et al. Certain dietary habits contribute to the functional dyspepsia in South China rural area. Med Sci Monit Basic Res. 2017;23:3942?51. DOI:
29 Chang FY, Chen PH, Wu TC, Pan WH, Chang HY, Wu SJ, et al. Prevalence of functional gastrointestinal disorders in Taiwan: questionnaire-based survey for adults based on the Rome III criteria. Asia Pac J Clin Nutr. 2012;21:594?600. PMID: 23017318.
30 Huang R, Ho S, Lo W, Lam T. Physical activity and constipation in Hong Kong adolescence. PLoS One. 2014;9:e90193. DOI:
31 Heiman DL, Lishnak TS, Trojian TH. Irritable bowel syndrome in athletes and exercise. Curr Sports Med Rep. 2008;7:100-3. DOI:
32 Matsuzaki J, Suzuki H, Masaoka T, Tanaka K, Mori H, Kanai T. Influence of regular exercise on gastric emptying in healthy men: a pilot study. J Clin Biochem Nutr. 2016;59:130?3. DOI:
How to Cite
Alatas F, Salsabila K, - N, Amalia N, Hanafi G. Functional gastrointestinal disorders and nutritional status in junior high school students. PI [Internet]. 25Jul.2022 [cited 29Feb.2024];62(4):243-. Available from:
Pediatric Gastrohepatology
Received 2021-04-06
Accepted 2022-07-25
Published 2022-07-25