The care of constipated children in primary care in different countries
Source: Acta Pædiatrica, Volume 101, Number 6, 1 June 2012 , pp. 677-680(4)
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
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