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Managing children with constipation: a community perspective
1Department of Paediatrics, John Radcliffe Hospital, Oxford.
Insights
Pediatric constipation is common and complex, often stemming from poor understanding and management. Effective strategies involve dietary changes, behavior modification, laxatives, and regular follow-up for successful treatment.
Area of Science:
- Pediatrics
- Gastroenterology
- Nursing
Background:
- Constipation is a frequent and complex pediatric issue, often starting around weaning or potty training.
- It causes distress for children and families, with high treatment failure rates due to misunderstanding pathophysiology and management.
- Symptoms include infrequent stools, pain, distress, and stool withholding.
Purpose of the Study:
- To explain the nature of childhood constipation.
- To outline successful treatment and management strategies for the primary health care team.
- To highlight the role of nurses in managing this chronic condition.
Main Methods:
- Review of common causes including low fiber/fluid intake, emotional factors, infection, and routine changes.
- Discussion of management approaches: increased fiber and fluid intake, behavior modification, and laxative use.
- Emphasis on the necessity of regular follow-up for effective treatment.
Main Results:
- Treatment failure is often linked to poor understanding of constipation's pathophysiology and inappropriate management.
- A multi-faceted approach including diet, behavior, medication, and follow-up is crucial.
- Nursing-led management is effective and well-accepted by parents.
Conclusions:
- Successful management of pediatric constipation requires a comprehensive understanding and consistent application of treatment strategies.
- Regular follow-up and a collaborative primary health care approach are essential for positive outcomes.
- Nurses play a vital role in the effective and acceptable management of chronic constipation in children.
Abstract:
Two clinical nurse specialists explain the nature of constipation in children and how the primary health care team can achieve successful treatment and management strategies for this condition. Constipation in children is a common and often complex problem. It may begin at four months of age in relation to weaning, or at around two years of age in relation to potty training. Constipation can be a distressing problem for the child and the family. Treatment failure rates are high, frequently reflecting poor understanding of the pathophysiology of constipation and inappropriate management. Symptoms include infrequent defaecation, pain and distress and refusal to defaecate. Causes include a poor intake of dietary fibre and fluid, emotional disturbances, possibly intercurrent infection and change in routine. Management of children with constipation includes an increase in dietary fibre and fluids, behaviour modification and laxative medication. For treatment to be effective there should be regular follow-up. Management of this chronic problem by nurses is viewed as effective and acceptable to parents.