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Implementation of the 2014 ESPGHAN/NASPGHAN Guideline for Childhood Functional Constipation.

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eMediNexus    12 December 2017

A recent study published in the Journal of Pediatric Gastroenterology and Nutrition assessed whether physicians approach children with functional constipation according to the 2014 ESPGHAN/NASPGHAN guideline. Here, 328 pediatricians and pediatric gastroenterologists from Netherlands and the U.S. were invited to participate in an anonymous survey, which utilized a self-developed questionnaire aimed at the evaluation and treatment of children with constipation. The results showed that 31% of responders were not familiar with the guideline, of which, 38% were from the U.S., whereas 16% were Dutch. In a majority of cases, perianal inspection was conducted by 78% of responders, while digital rectal inspection was frequently done by 42% and inquiry about sexual abuse was made by 18%. Commonly reported reasons for omitting these items were perceived patient or parental discomfort. On the other hand, most implemented initial non-pharmacological interventions included: a toilet training program, optimizing fluid and fiber intake, a defecation diary and a reward system. Furthermore, polyethylene glycol was the most prescribed medication for disimpaction (68%) and for maintenance treatment (57% for infants, 97% for children ≥1 year). The findings were summarized as: many responders were not familiar with the ESPGHAN/NASPGHAN guideline for functional constipation, yet therapeutic decisions correlated fairly well with recommendations from the guideline, especially for children ≥1 year. Polyethylene glycol was the most prescribed medication for disimpaction and maintenance treatment.

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