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Using laxatives and/or enemas to accelerate the diagnosis in children presenting with acute abdominal pain: a

Marjolijn E W Timmerman1, Monika Trzpis2, Paul M A Broens1,2

  • 1Division of Pediatric Surgery, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

BMJ Paediatrics Open
|December 1, 2018
PubMed

Insights

This study investigates if laxatives and enemas can help diagnose acute abdominal pain in children, potentially speeding up treatment for constipation and reducing emergency department visits.

Area of Science:

  • Pediatric emergency medicine
  • Gastroenterology

Background:

  • Acute abdominal pain in children often mimics appendicitis, leading to misdiagnosis of constipation.
  • Differentiating constipation from appendicitis is challenging due to similar symptoms and lack of clear diagnostic criteria.
  • Missed constipation diagnoses result in repeated emergency department visits.

Purpose of the Study:

  • To improve the diagnostic process for acute abdominal pain in children.
  • To accelerate adequate treatment for constipation by supporting fecal evacuation.
  • To reduce the need for repeated emergency department consultations.

Main Methods:

  • An unblinded randomized controlled trial involving children aged 5-18 with acute abdominal pain and suspected appendicitis.
  • Children requiring a second consultation after initial assessment were randomized.
  • Intervention group received laxatives/enemas; control group received no medication.

Main Results:

  • Primary outcome: differences in abdominal pain scores (FACES, VAS) at consultations.
  • Secondary outcome: number of consultations needed for final diagnosis.
  • Laxatives and enemas are safe and effective for pediatric constipation.

Conclusions:

  • Supporting fecal evacuation may improve diagnosis and treatment of constipation in children with acute abdominal pain.
  • This approach could potentially reduce healthcare utilization for undiagnosed constipation.
  • Further research is needed to validate these findings and establish definitive diagnostic guidelines.
Abstract

Keywords:
gastroenterologypaediatric surgery

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