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Knowledge and Practices of Pediatricians Regarding Functional Constipation in the State of Minas Gerais, Brazil
Marcia R F Torres1, Maria do Carmo B de Melo, Flávia A C Purcino
1*Department of Pediatrics, Gastroenterology Division, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Minas Gerais †Universidade Federal de Minas Gerais (UFMG), Minas Gerais ‡Universidade de São Paulo (USP), São Paulo §Santa Casa de Misericórdia de Belo Horizonte ||Hospital Odilon Behrens, Belo Horizonte, Minas Gerais, Brazil.
Insights
Pediatricians show inadequate knowledge of functional constipation (FC) and its diagnostic criteria. Improved medical education is recommended to enhance patient care for this common pediatric issue.
Area of Science:
- Pediatrics
- Gastroenterology
- Medical Education
Background:
- Functional constipation (FC) is a common pediatric condition with significant impact on quality of life.
- Current knowledge gaps among pediatricians may lead to suboptimal diagnosis and management of FC.
Purpose of the Study:
- To assess the knowledge, approaches, and practices of pediatricians concerning functional constipation.
- To identify specific areas of deficiency in understanding and managing FC.
Main Methods:
- A cross-sectional regional study utilizing a semistructured questionnaire.
- The questionnaire assessed knowledge of Rome III criteria, risk factors, dietary components, examination practices, and treatment preferences.
Main Results:
- A majority of pediatricians (76.7%) did not recognize the Rome III criteria for FC.
- Significant variations observed in diagnostic approaches and treatment strategies between general pediatricians and pediatric gastroenterologists.
- Most pediatricians underestimated the required treatment duration for FC.
Conclusions:
- Pediatrician knowledge regarding functional constipation is insufficient, highlighting a need for enhanced training.
- Current pediatric residency programs may not adequately address FC, impacting public health attention.
- Recommendations include integrating comprehensive FC education into medical school and residency curricula.
Objectives:
The aim of the study was to analyze the knowledge, approaches, and practices of pediatricians participating in a regional pediatric conference regarding functional constipation (FC) to identify knowledge gaps.
Methods:
Cross-sectional regional study based on a semistructured questionnaire related to the Rome III criteria and the participant profiles.
Results:
Of 400 questionnaires distributed, 264 (66.0%) were completed. Most pediatricians (76.7%) did not recognize the Rome III criteria, but the majority did recognize the following risk factors for FC: low-fiber diet (97.8%), family history (86.6%), onset of toilet training (76.4%), and weaning (62.4%). Foods considered high in fiber were oats (95.7%), leafy vegetables (95.3%), and wheat bran (93.2%). Digital rectal examination was not performed by 57.7% of nongastroenterologists. Complementary examinations were ordered in 27.5% and 72.5% of patients by general pediatricians and pediatric gastroenterologists, respectively, although the sample of gastroenterologists was not representative. The most prescribed drugs by nongastroenterologists were mineral oil (72.6%), magnesium hydroxide (52.1%), lactulose (41.0%), and polyethylene glycol (25.2%). Pediatric gastroenterologists prescribed magnesium hydroxide (91.7%), polyethylene glycol (91.7%), and mineral oil (58.3%). Most pediatricians (70.0%) considered the average treatment duration to be less than 1 year, although gastroenterologists considered it to be more than 1 year (54.6%).
Conclusions:
The knowledge of pediatricians regarding FC is inadequate. Constipation may not receive the public health attention it deserves within pediatric residency programs. The authors suggest that better education regarding FC should be included in medical school and residency program curricula to improve patient care.
