Related Experiment Video
Updated: Feb 20, 2026
Electroacupuncture Combined with Chinese Medicine Ironing Therapy for Functional Constipation
Published on: July 5, 2024
Awareness and Implementation of the 2014 ESPGHAN/NASPGHAN Guideline for Childhood Functional Constipation
Ilan J N Koppen1, Mana H Vriesman1, Merit M Tabbers1
1Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
Insights
Physician adherence to pediatric functional constipation guidelines varied, with many unaware of recommendations. However, treatment choices aligned well with guidelines, particularly for older children, indicating a need for improved guideline implementation strategies.
Area of Science:
- Pediatric Gastroenterology
- Clinical Practice Guidelines
Background:
- Functional constipation is a common pediatric issue.
- Current guidelines exist to standardize evaluation and treatment.
Purpose of the Study:
- To evaluate physician adherence to the 2014 European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)/North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guideline for functional constipation.
Main Methods:
- An anonymous survey with 19 multiple-choice questions was distributed to pediatricians and pediatric gastroenterologists in the Netherlands and the United States.
- The questionnaire covered the evaluation and treatment of children with constipation.
Main Results:
- 31% of 328 physicians were unfamiliar with the guideline, with higher rates in the US (38%) than the Netherlands (16%).
- Commonly used non-pharmacological interventions included toilet training and optimizing fluid/fiber intake.
- Polyethylene glycol was the most prescribed medication for disimpaction and maintenance therapy.
Conclusions:
- Physician familiarity with the ESPGHAN/NASPGHAN guideline for functional constipation needs improvement.
- Despite low guideline awareness, treatment decisions generally aligned with recommendations, especially for children over one year old.
- Developing digital learning tools is suggested to enhance guideline implementation.
Objective:
The aim of the study was to assess whether physicians approach children with functional constipation according to the 2014 European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)/North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guideline.
Methods:
We invited pediatricians and pediatric gastroenterologists in the Netherlands and the United States to participate in this anonymous survey using a self-developed questionnaire containing 19 multiple choice questions concerning evaluation and treatment of children with constipation.
Results:
We included 328 physicians (67% from the United States, 34% from the Netherlands). The majority of US responders (53%) worked in primary care, whereas all Dutch responders worked in a hospital. In total, 31% of responders were not familiar with the guideline (38% US responders vs 16% Dutch responders, P < 0.001). Perianal inspection was frequently ("often" or "always" on a 5-point Likert scale) conducted by 78% of responders. Digital rectal examination was frequently done by 42%. Inquiry about sexual abuse was made by 18%. Commonly reported reasons for omitting these items were perceived patient or parental discomfort. Most frequently implemented initial nonpharmacological interventions included a toilet training program (89%), optimizing fluid and fiber intake (86% and 81%), a defecation diary (62%), and a reward system (60%). Polyethylene glycol was the most prescribed medication for disimpaction (68%) and maintenance treatment (57% for infants, 97% for children ≥1 year).
Conclusions:
Many responders were not familiar with the ESPGHAN/NASPGHAN guideline for functional constipation. Nonetheless, therapeutic decisions correlated fairly well with recommendations from the guideline, especially for children 1 year of age or older. Guideline awareness and adherence remain to be improved. Future studies should focus on exploring strategies to improve guideline implementation through the development of digital learning tools.
More Related Videos
07:20Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
03:50Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease
Published on: August 18, 2023
Related Concept Videos
01:21Drugs for Treatment of Constipation-Predominant IBS
01:30Irritable Bowel Syndrome III: Medical and Nursing Management
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:29Assessment of the Gastrointestinal System II: Health Perception Pattern
Health Perception Patterns
Health perception patterns offer valuable insights into a patient's lifestyle habits and how they may impact their GI health. These patterns include:
01:22Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives
Bulk-forming laxatives, such as psyllium, methylcellulose, and polycarbophil, absorb water in the intestine, increasing stool bulk and promoting bowel movement. This...
01:20Gastrointestinal Motility Disorders