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Electroacupuncture Combined with Chinese Medicine Ironing Therapy for Functional Constipation
Published on: July 5, 2024
Management of children with functional constipation referred to tertiary care
Giovanna Roberta Camargo de Campos1, Natascha Silva Sandy2, Elizete Aparecida Lomazi1
1Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil.
Insights
Functional constipation (FC) management in children often requires specialized care, with many cases improving with established treatment plans, indicating that "refractory" constipation may not be intractable.
Area of Science:
- Pediatrics
- Gastroenterology
Background:
- Functional constipation (FC) is a common pediatric condition requiring effective management strategies.
- Referral to specialized care is often necessary for children with persistent FC symptoms.
Purpose of the Study:
- To describe the management of pediatric functional constipation (FC).
- To compare initial referral treatments with those during specialized follow-up.
- To analyze outcomes in children with FC treated at a tertiary care center.
Main Methods:
- Retrospective analysis of children aged 4-18 years diagnosed with FC.
- Data collected from 2006-2019, including demographics, treatments, and follow-up duration.
- Institutional protocol guided FC management.
Main Results:
- 79 children with FC were analyzed; 59% were male, with a mean age of 6.4 years at referral.
- Therapies like polyethylene glycol, enemas, magnesium hydroxide, and bisacodyl increased during follow-up.
- Over half of patients experienced improvement (31%) or complete resolution (19.5%); 30.4% had unchanged symptoms.
Conclusions:
- Many children with FC referred to specialized care may not receive optimal initial therapy.
- A well-established care plan can successfully treat many cases labeled as "refractory" FC.
- Intractable constipation is less common than perceived; effective management is key.
Objectives:
To describe the management, to compare treatment at initial referral vs. during specialized follow-up, and to describe outcomes of children with functional constipation (FC) referred to a Brazilian tertiary care center.
Methods:
Retrospective study, including children (4-18 years) with FC followed at a single center from 2006 to 2019. Demographics, treatments, time of follow-up, and outcomes were analyzed. The management of FC followed an institutional protocol.
Results:
104 patients were identified, 79 were eligible and included in the analysis: 59% male, mean age at referral was 6.4 years, and mean duration of symptoms was 4.4 years. There were significant changes in the therapy(ies) used at the time of referral compared to during follow-up, with a noticeable increase in the frequency of the use of polyethylene glycol, enemas, magnesium hydroxide, and bisacodyl; 5.1% received trans-anal irrigation, and 3.8% underwent surgery. Outcomes were favorable in more than half of the cases: 31% improved; 19.5% had complete resolution and 2.5% were transferred back to primary care. Symptoms remained unchanged in 30.4%, and no patients experienced worsening of symptoms. The mean duration of follow-up was 2.8 years. When comparing patients with favorable vs. unfavorable outcomes, the authors did not identify significant differences in gender, age, therapies used, duration of symptoms, or length of follow-up.
Conclusions:
Children with FC are often referred to specialized care not receiving optimal therapy. Many patients whose FC was labeled "refractory" may be treated successfully with a well-established plan of care, and do not truly present intractable constipation.
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