Diagnosis and management of idiopathic childhood constipation: summary of NICE guidance

Bardisa-Ezcurra, Lauren; Ullman, Roz; Gordon, Jenny

doi:10.1136/bmj.c2585

Cited by 76 publications

(82 citation statements)

References 4 publications

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“…Another cause to explain the reduction of reported pain in the OF:IN as well as the placebo group may be the dietary advice provided to all children. In fact, in some cases, constipation is improved by a higher consumption of fibre and fluids (Bardisa-Ezcurra et al 2010), and dietary advice is intended to promote these habits. However, it does not seem to be the case in our study as we found an unexpected reduction of the fibre intake during the intervention, compared with the intake at baseline, in both study groups of children.…”

Section: Discussionmentioning

confidence: 99%

The use of inulin-type fructans improves stool consistency in constipated children. A randomised clinical trial: pilot study

Closa‐Monasterolo

Ferré

Castillejo-DeVillasante

et al. 2016

International Journal of Food Sciences and Nutrition

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Background: Constipation is a common disorder in children. Objective: The objective of this study is to assess the beneficial effects of a daily supplementation with Orafti V R inulin-type fructans in 2-5 year old constipated children. Methods: Double-blind, randomised, placebo-controlled parallel group trial where constipated children received two doses of 2 g Orafti V R inulin-type fructans (OF:IN) or placebo (maltodextrin) for 6 weeks. Primary outcome was stool consistency. Secondary outcomes were stool frequency and gastrointestinal symptoms. Results: Twenty-two children were included, 17 completed the study protocol (nine and eight for the control and the OF:IN group, respectively). Results showed that Orafti V R inulin-type fructans supplemented children had softer stools (p ¼ .003). The longitudinal analysis showed no significant changes in controls, whereas supplemented children increased their stool consistency from 2.2 to 2.6 on the modified Bristol scale for children (five items instead of seven) (p ¼ .040). Conclusions: Prebiotic inulin-type fructans supplementation improves stool consistency in constipated 2-5-year old children.

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Section: Discussionmentioning

confidence: 99%

The use of inulin-type fructans improves stool consistency in constipated children. A randomised clinical trial: pilot study

Closa‐Monasterolo

Ferré

Castillejo-DeVillasante

et al. 2016

International Journal of Food Sciences and Nutrition

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“…In this regard, the NICE guidelines for biopsy in children with chronic constipation (published in 2010), 33 although a helpful guide to the selection of patients, are not infallible and are currently being reevaluated.…”

Section: Controversies and Diagnostic Dilemmas In Hscrmentioning

confidence: 99%

Hirschsprung disease: current perspectives

Moore¹

2016

OAS

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Hirschsprung disease is a complex congenital condition of the intestine, which is recognized as being of genetic origin and results from a disturbance of the normal development of the enteric nervous system. As a result, aganglionosis of the distal bowel occurs. It is the most common cause of a low intestinal obstruction in the neonate as well as older children. Occurring as an isolated condition in 70% of cases, it may be associated with other associated congenital abnormalities as well as a number of syndromic phenotypes. A number of distinct genetic sites have been identified in these syndromic phenotypes, which identify potential underlying genetic associations of the disease and indicate the probable gene-gene interaction in its pathogenesis. This review looks at the prevalence, congenital associations, and possible genetic factors influencing the development of Hirschsprung disease. Diagnostic dilemmas, surgical management, potential postsurgical complications, and outcomes are also explored.

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“…The practical guide proposed by National Institute for Health and Clinical Excellence (NICE) states that a detailed history and a thorough physical abdominal examination are enough to attain the diagnosis 10. This is also the final conclusion of the guidelines proposed by ESPGHAN and NASPGHAN, suggesting that the diagnosis is primarily clinical and that complementary tests are not necessary to confirm the disease 7.…”

Section: Discussionmentioning

confidence: 99%

“…Such tests may be indicated when there is diagnostic uncertainty (patient does not meet the clinical criteria), or when there is strong suspicion of an underlying organic disease, such as hypothyroidism, allergy to cow's milk protein and celiac disease and not for patients with a clear picture of functional constipation, as in this study case 17 , 10 , 15 …”

Section: Discussionmentioning

confidence: 99%

Pediatrician's knowledge on the approach of functional constipation

Vieira

Negrelle

Webber

et al. 2016

Revista Paulista de Pediatria (English Edition)

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Objective:To evaluate the pediatrician's knowledge regarding the diagnostic and therapeutic approach of childhood functional constipation.Methods:A descriptive cross-sectional study was performed with the application of a self-administered questionnaire concerning a hypothetical clinical case of childhood functional constipation with fecal incontinence to physicians (n=297) randomly interviewed at the 36th Brazilian Congress of Pediatrics in 2013.Results:The majority of the participants were females, the mean age was 44.1 years, the mean time of professional practice was 18.8 years; 56.9% were Board Certified by the Brazilian Society of Pediatrics. Additional tests were ordered by 40.4%; including abdominal radiography (19.5%), barium enema (10.4%), laboratory tests (9.8%), abdominal ultrasound (6.7%), colonoscopy (2.4%), manometry and rectal biopsy (both 1.7%). The most common interventions included lactulose (26.6%), mineral oil (17.5%), polyethylene glycol (14.5%), fiber supplement (9.1%) and milk of magnesia (5.4%). Nutritional guidance (84.8%), fecal disimpaction (17.2%) and toilet training (19.5%) were also indicated.Conclusions:Our results show that pediatricians do not adhere to current recommendations for the management of childhood functional constipation, as unnecessary tests were ordered and the first-line treatment was not prescribed.

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Diagnosis and management of idiopathic childhood constipation: summary of NICE guidance

Cited by 76 publications

References 4 publications

The use of inulin-type fructans improves stool consistency in constipated children. A randomised clinical trial: pilot study

The use of inulin-type fructans improves stool consistency in constipated children. A randomised clinical trial: pilot study

Hirschsprung disease: current perspectives

Pediatrician's knowledge on the approach of functional constipation

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