Pediatrician's knowledge on the approach of functional constipation

• Main Author: Vieira,Mario C.
• Publication Date: 2016
• Other Authors: Negrelle,Isadora Carolina Krueger, Webber,Karla Ulaf, Gosdal,Marjorie, Truppel,Sabine Krüger, Kusma,Solena Ziemer
• Format: Article
• Language: eng
• Source: Revista Paulista de Pediatria (Ed. Português. Online)
• Download full: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822016000400425
• topic: Constipation; Pediatrics; Diagnostic; Treatment

Abstract Objective: To evaluate the pediatrician's knowledge regarding the diagnostic and therapeutic approach of childhood functional constipation. Methods: A descriptive cross-sectional study was performed with the application of a self-administered questionnaire concerning a hypothetical clinical case of childhood functional constipation with fecal incontinence to physicians (n=297) randomly interviewed at the 36th Brazilian Congress of Pediatrics in 2013. Results: The majority of the participants were females, the mean age was 44.1 years, the mean time of professional practice was 18.8 years; 56.9% were Board Certified by the Brazilian Society of Pediatrics. Additional tests were ordered by 40.4%; including abdominal radiography (19.5%), barium enema (10.4%), laboratory tests (9.8%), abdominal ultrasound (6.7%), colonoscopy (2.4%), manometry and rectal biopsy (both 1.7%). The most common interventions included lactulose (26.6%), mineral oil (17.5%), polyethylene glycol (14.5%), fiber supplement (9.1%) and milk of magnesia (5.4%). Nutritional guidance (84.8%), fecal disimpaction (17.2%) and toilet training (19.5%) were also indicated. Conclusions: Our results show that pediatricians do not adhere to current recommendations for the management of childhood functional constipation, as unnecessary tests were ordered and the first-line treatment was not prescribed.