Pediatrician's knowledge on the approach of functional constipation

Area of Science:

• Pediatrics
• Gastroenterology
• Clinical Practice Guidelines

Background:

• Childhood functional constipation is a common condition requiring appropriate diagnostic and therapeutic strategies.
• Adherence to established clinical guidelines is crucial for effective management and improved patient outcomes.

Purpose of the Study:

• To assess pediatricians' knowledge and practices concerning the diagnosis and treatment of childhood functional constipation.
• To identify discrepancies between current practices and evidence-based recommendations.

Main Methods:

• A descriptive cross-sectional study was conducted.
• A self-administered questionnaire was used, presenting a hypothetical clinical case of childhood functional constipation with fecal incontinence.
• The study involved 297 physicians interviewed at the 36th Brazilian Congress of Pediatrics in 2013.

Main Results:

• A significant proportion of pediatricians ordered additional tests, such as abdominal radiography and barium enema, which are often not recommended.
• While some first-line treatments like lactulose and polyethylene glycol were used, their prescription rates were suboptimal.
• Nutritional guidance, fecal disimpaction, and toilet training were indicated by a majority of participants.

Conclusions:

• Pediatricians' current approaches to childhood functional constipation deviate from established recommendations.
• There is a need for improved education and training to ensure adherence to best practices in diagnosing and treating this condition.