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Characteristics of children under 5 referred to hospital with constipation: a one-year prospective study
B Gallagher1, D West, J W Puntis
1Children's Centre, Leeds General Infirmary, UK.
Insights
Constipation in preschool children causes distress, but early diagnosis and treatment improve outcomes. Standardized community care guidelines and multidisciplinary assessments for refractory cases are recommended.
Area of Science:
- Pediatrics
- Gastroenterology
- Child Psychology
Background:
- Constipation is a common issue in preschool children, causing significant distress to both the child and family.
- While most cases are idiopathic with good prognosis, variations in symptom duration and treatment exist.
- Psychological factors and behavioral management are often overlooked in initial care.
Purpose of the Study:
- To investigate current practices in managing constipation in preschool children.
- To identify areas for improvement in diagnosis and treatment.
- To propose recommendations for standardized care and specialist referral.
Main Methods:
- A prospective study was conducted over one year in a pediatric unit.
- 42 new referrals of children under 5 with constipation were identified.
- Data on symptom duration, treatments, and overlooked factors were collected.
Main Results:
- Significant variation in symptom duration and treatment approaches was observed before specialist referral.
- Psychological factors and behavioral modification strategies were frequently neglected.
- The study identified a need for standardized treatment guidelines in community care.
Conclusions:
- Implementing community care guidelines can standardize and improve constipation management.
- Refractory constipation cases benefit from a multidisciplinary approach.
- Specialist assessment should include pediatricians, pediatric surgeons, and mental health professionals.
Abstract:
Constipation in the pre-school child can cause considerable distress to the individual and to the family. Most cases are idiopathic and with early diagnosis and effective treatment prognosis is good. In a teaching hospital paediatric unit, a year-long prospective study identified 42 new referrals for constipation in children under 5. Before referral for a specialist opinion there appeared to be considerable variation in both duration of symptoms and treatment given. Psychological factors in the family, as well as advice regarding simple behaviour modification and management of common secondary behavioural problems, seemed largely overlooked. Guidelines for for treating constipation in the community could help standardise and improve care. For children with refractory constipation referred to a specialist centre, we recommended a multidisciplinary assessment including paediatrician, paediatric surgeon and member of the child mental health team.