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Infantile Colic: A Survey of Physicians in Pakistan
Muhammad Saif Jalal1, Syed Zafar Mehdi1, Jalal Uddin Akber1
1Department of Pediatrics, Fatima Hospital, Baqai Medical University, Karachi, Pakistan.
Insights
Most Pakistani physicians use established criteria for infantile colic diagnosis, but treatment varies widely. Educational initiatives are needed for rural and general practitioners to improve management and reduce patient burden.
Area of Science:
- Pediatrics
- Gastroenterology
- Public Health
Background:
- Infantile colic is a common condition with established diagnostic criteria (Rome IV).
- A universally accepted management strategy for infantile colic is still lacking.
- Understanding current diagnostic and management practices in Pakistan is crucial.
Purpose of the Study:
- To evaluate diagnostic criteria for infantile colic used in Pakistan.
- To assess management strategies and perceived prevalence of infantile colic.
- To understand the impact of infantile colic on physicians and parents in Pakistan.
Main Methods:
- A questionnaire was distributed to 1,256 physicians in Pakistan.
- 800 physician responses were analyzed for diagnostic and management practices.
- Data on perceived prevalence and impact were collected.
Main Results:
- Most physicians use Wessel and Rome IV criteria, but some rely on a vague "cries a lot" definition.
- Estimated infantile colic prevalence ranges from 21-40%.
- Management strategies include reassurance, herbal teas, formula changes, probiotics, and antibiotics; adherence to guidelines varies.
Conclusions:
- Physicians in Pakistan generally diagnose infantile colic according to guidelines.
- Treatment planning often deviates from established guidelines.
- Targeted educational programs are recommended for rural and general physicians to optimize care and minimize unnecessary interventions.
Purpose:
Infantile colic diagnostic criteria were established by Rome IV. A universally accepted management remains to be established. We aimed to evaluate diagnostic criteria, management strategies, and perceived regional prevalence of infantile colic in Pakistan, as well as its effect on physicians and parents.
Methods:
A questionnaire was distributed amongst 1,256 physicians.
Results:
We received 800 replies. Wessel and Rome IV criteria were used by most physicians for diagnosis; however, the response "any infant who cries a lot" was selected by older physicians (48% of those over 60 years), physicians in rural areas (32%), physicians practicing in private clinics (27%), and general physicians (30%). Estimated prevalence of infantile colic ranges from 21-40%. Reassurance was the most widely recommended management strategy followed by herbal teas (51%), switching to a different formula (49%), probiotics (28%) and antibiotics (26%), discontinuation of breastfeeding (14%), elimination of dairy products from the breastfeeding mothers' diet (6%), and the administration of colic drops (1%). Most physicians considered the negative impact of colic on their personal lives and the parents as mild-to-moderate. Notably, 38% of percent of physicians routinely screened for maternal depression, and 45% of physicians were aware of the association between infantile colic and shaken baby syndrome.
Conclusion:
Most physicians in Pakistan diagnose and manage infantile colic according to the established guidelines. However, the guidelines pertaining to treatment planning are not followed. Educational efforts directed toward general physicians and doctors practicing in rural areas and clinics must be implemented to avoid unnecessary testing and treatment burden.
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