Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec;34(4):425-431.
doi: 10.1016/j.rpped.2016.05.003. Epub 2016 Jun 17.

Pediatrician's knowledge on the approach of functional constipation

[Article in English, Portuguese]
Mario C Vieira  1 , Isadora Carolina Krueger Negrelle  2 , Karla Ulaf Webber  2 , Marjorie Gosdal  3 , Sabine Krüger Truppel  4 , Solena Ziemer Kusma  2
Affiliations

Pediatrician's knowledge on the approach of functional constipation

[Article in English, Portuguese]
Mario C Vieira et al. Rev Paul Pediatr. 2016 Dec.

Abstract
in English, Portuguese

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.

Objetivo:: Identificar o conhecimento do pediatra quanto ao manejo diagnóstico e terapêutico da criança com constipação intestinal funcional.

Métodos:: Estudo transversal descritivo com amostra constituída de médicos (n=297) entrevistados no 36º Congresso Brasileiro de Pediatria de 2013. Foi usado um questionário autoadministrado referente a um caso clínico hipotético de constipação intestinal.

Resultados:: Foi observada maior proporção de pediatras do sexo feminino, média de 44,1 anos, tempo de formação médio de 18,8 anos, 56,9% portadores de título de especialista pela Sociedade Brasileira de Pediatria. Exames complementares foram solicitados por 40,4%, a radiografia abdominal foi o mais requisitado (19,5%), seguido por enema opaco (10,4%), exames laboratoriais (9,8%), ultrassonografia de abdome (6,7%), colonoscopia (2,4%), manometria e biópsia (ambas 1,7%). Para o manejo foi sugerida a prescrição de lactulose (26,6%), óleo mineral (17,5%), polietilenoglicol (14,5%), suplemento de fibras (9,1%) e leite de magnésia (5,4%). Orientação alimentar (84,8%), desimpactação fecal (17,2%) e treinamento de toalete (19,5%) também foram indicadas.

Conclusões:: Evidencia-se uma discordância entre o manejo sugerido pelos pediatras e a conduta preconizada pela literatura disponível atualmente, uma vez que foram solicitados exames complementares desnecessários e não foi recomendada a orientação terapêutica considerada de primeira linha.

Keywords: Constipation; Constipação intestinal; Diagnostic; Diagnóstico; Pediatria; Pediatrics; Tratamento; Treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Association between time since graduation and diagnostic and therapeutic procedures.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Tabbers MM, Boluyt N, Berger MY, Benninga MA. Clinical practice: diagnosis and treatment of functional constipation. Eur J Pediatr. 2011;170:955–963. - PubMed
    1. Morais MB, Maffei HV. Constipation. J Pediatr (Rio J) 2000;76:S147–S156. - PubMed
    1. Walia R, Mulhearn N, Khan R, Cuffari C. Chronic constipation in children: an overview. Pract Gastroenterol. 2013;17:19–34.
    1. Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2006;43:e1–e13. - PubMed
    1. Motta ME, Silva GA. Constipação crônica. In: Lopez FA, Campos D Júnior, editors. Tratado de pediatria. Manole; São Paulo: 2010. pp. 983–993.