The care of constipated children in primary care in different countries

Authors: Burgers, Rosa; Bonanno, Elvira; Madarena, Elisa; Graziano, Francesca¹; Pensabene, Licia¹; Gardner, William²; Mousa, Hayat²; Benninga, Marc A³; Di Lorenzo, Carlo²

Source: Acta Pædiatrica, Volume 101, Number 6, 1 June 2012 , pp. 677-680(4)

Publisher: Wiley-Blackwell

Buy & download fulltext article:

Price: $48.00 plus tax (Refund Policy)

Abstract:

<title type="main">Abstract</title>

Aim: To investigate and compare the approach to childhood constipation by primary care physicians (PCP) in three Western countries to give insight into adherence to current guidelines and in actual care.

Methods: Prospective study utilizing a two-page survey regarding the approach to children suspected to have functional constipation (FC). A total of 413 of 1016 (41%) distributed surveys were returned out of which 383 were suitable for analysis. Surveys were answered anonymously. Survey responses were analysed and are reported in a descriptive way.

Results: In Italy, the Netherlands, and the USA, respectively, 75, 187 and 121 surveys were returned by PCP. The majority of PCP (62%) considered stool withholding as a result of painful defecation to be the most common cause of childhood constipation. Rectal examination was used as a standard diagnostic tool for the evaluation of FC by only 31% of PCP with significant differences among the countries (p < 0.05) and a minimum in the Netherlands (11%). Abdominal X-ray is used by 49% to diagnose FC. 63% of PCP were convinced that hard stool can be softened by drinking more water. Polyethylene glycol was the most common prescribed drug (85%). Significant differences were found among countries in the use of senna and bisacodyl suppositories (p < 0.05).

Conclusion: Significant differences in practice exist among PCP from different countries regarding the performance of a digital rectal examination, need for additional diagnostic tests and use of laxatives in childhood constipation.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1651-2227.2012.02632.x

Affiliations: 1: Department of Pediatrics, University of `Magna Græcia', Catanzaro, Italy 2: Nationwide Children's Hospital, Columbus, OH, USA 3: Emma Children's Hospital, Amsterdam Medical Center, Amsterdam, Netherlands

Publication date: 2012-06-01

The care of constipated children in primary care in different countries

Buy & download fulltext article:

Tools

Key

Text size:

Useful pages