Related Experiment Video

Updated: May 24, 2026

Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease
03:50

Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease

Published on: August 18, 2023

The care of constipated children in primary care in different countries

Rosa Burgers1, Elvira Bonanno, Elisa Madarena

  • 1Emma Children's Hospital, Amsterdam Medical Center, Netherlands. r.e.burgers@amc.nl

Acta Paediatrica (Oslo, Norway : 1992)
|February 23, 2012
PubMed

Insights

Primary care physicians in Italy, the Netherlands, and the USA show significant differences in diagnosing and treating childhood constipation, impacting guideline adherence. This study highlights variations in diagnostic tools and laxative use among these countries.

Area of Science:

  • Pediatrics
  • Gastroenterology
  • Primary Care Medicine

Background:

  • Childhood constipation is a common pediatric issue.
  • Current guidelines exist for managing functional constipation (FC).
  • Understanding primary care physician (PCP) practices is crucial for guideline adherence.

Purpose of the Study:

  • To compare the diagnostic and treatment approaches of PCPs in Italy, the Netherlands, and the USA regarding childhood constipation.
  • To assess adherence to current guidelines in actual clinical practice.
  • To identify variations in managing functional constipation.

Main Methods:

  • A prospective study involving a two-page anonymous survey distributed to PCPs.
  • The survey focused on the approach to children with suspected functional constipation.
  • 383 of 1016 distributed surveys were analyzed descriptively.

Main Results:

  • Significant international differences were observed in the use of digital rectal examinations (31% overall, lowest in the Netherlands at 11%) and abdominal X-rays (49%).
  • PCPs' beliefs about softening stool with water (63%) and prescribing polyethylene glycol (85%) varied.
  • Variations in the use of senna and bisacodyl suppositories were noted across countries.

Conclusions:

  • Substantial practice variations exist among PCPs in different countries concerning childhood constipation management.
  • Differences are evident in digital rectal examination performance, diagnostic testing, and laxative prescriptions.
  • These disparities suggest potential gaps in guideline implementation for childhood constipation.
Abstract

Related Concept Videos

Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
Primary Healthcare Services01:30

Primary Healthcare Services

Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome III: Medical and Nursing Management01:30

Irritable Bowel Syndrome III: Medical and Nursing Management

Managing Irritable Bowel Syndrome (IBS) involves a multifaceted approach, including lifestyle modifications, dietary changes, and medication.
Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...