(From the November 2014 Issue of PediatricsOnline)
Among children with no underlying medical disease, symptoms such as infrequent or painful defecation, excessive straining to stool or fecal incontinence are referred to as functional constipation. The condition is believed to affect an estimated 5 percent of children worldwide each year and results in significant family distress and health care expense. Proper identification, treatment and, when necessary, referral to a specialist can help address the root cause of the symptoms and optimize the treatment plan.
In early 2014, the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition released updated guidelines for the evaluation and treatment of functional constipation in infants and children. Carlo Di Lorenzo, MD, chief of the Division of Gastroenterology, Hepatology and Nutrition at Nationwide Children’s Hospital, and current NASPGHAN president, was the co-lead author of the international guidelines. A leading expert in gastrointestinal motility and functional disorders, Dr. Di Lorenzo assisted in the development of the practice tool below.
This physician-focused tool summarizes NASPGHAN’s recommendations and offers a concise guide to the in-office identification and management of pediatric constipation, as well as instructions on when to refer a patient for evaluation by a specialist.