Childhood constipation: recognition, management and the role of the nurse

Abstract

Constipation is a common childhood condition that health professionals will encounter in many different settings. The majority of these cases of childhood constipation are idiopathic in nature. It is considered to exhibit the 'tip of the iceberg' phenomenon as a large number of cases remain undetected due to under-recognition by families, embarrassment regarding the condition, fear of receiving a negative response from health professionals, or parental belief there is actually something more seriously wrong and failure to accept the diagnosis. Prompt evaluation and management is likely to be associated with better outcomes. To ensure this, fast recognition of symptoms, with care taken to exclude any 'red flag' symptoms that could indicate an organic cause and subsequently a different treatment pathway, is essential. Nurses, given their regular contact with families in different settings, are suitably placed to detect these symptoms early and can play a vital role in successful management of the condition. Laxatives are the first line in management of constipation. Polyethylene glycol 3350 is the laxative that evidence-based guidelines from the National Institute for Health and Care Excellence (2010) recommend as the initial pharmacological management. Advice should also be given about supportive measures, including diet and lifestyle changes.

Disfunção vesical e intestinal na infância: abordagem multi-metodológica

“…Torna-se evidente o papel do enfermeiro especialista na abordagem e manejo dos sintomas urinários e/ou intestinais, visto que esses sintomas, por vezes, não são abordados e diagnosticados por profissionais não-especialistas, além da posição privilegiada destes profissionais na detecção precoce de disfunções e na realização de uma abordagem voltada para a compreensão da convivência familiar e suas experiências com os sintomas. (26,27,31,32) Por fim, algumas narrativas refletiram a importância do fornecimento de informações adequadas para a aquisição de conhecimento sobre DVI pela família, fator que possibilitou a compreensão e adesão ao tratamento proposto. Sabe-se que a identificação e tratamento precoce da DVI são fatores essenciais para evitar repercussões sociais e clínicas com impactos negativos.…”