Conhecimento do pediatra sobre o manejo da constipação intestinal funcional

IF 1.4 Q3 PEDIATRICS Revista Paulista De Pediatria Pub Date : 2016-12-01 DOI:10.1016/j.rpped.2016.05.003

Mario C. Vieira , Isadora Carolina Krueger Negrelle , Karla Ulaf Webber , Marjorie Gosdal , Sabine Krüger Truppel , Solena Ziemer Kusma

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Abstract

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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儿科医生对功能性肠便秘处理的知识

目的评价儿科医生对儿童功能性便秘的诊断和治疗方法的认识。方法采用自填问卷对2013年第36届巴西儿科大会上随机采访的297名医生进行描述性横断面研究，问卷涉及一个假设的儿童期功能性便秘伴大便失禁的临床病例。结果调查对象以女性居多，平均年龄44.1岁，平均执业时间18.8年;56.9%的人获得了巴西儿科协会的认证。40.4%的人要求进行额外的检查;包括腹部x线摄影(19.5%)、钡灌肠(10.4%)、实验室检查(9.8%)、腹部超声(6.7%)、结肠镜检查(2.4%)、测压和直肠活检(均为1.7%)。最常见的干预措施包括乳果糖(26.6%)、矿物油(17.5%)、聚乙二醇(14.5%)、纤维补充剂(9.1%)和氧化镁乳(5.4%)。营养指导(84.8%)、排便(17.2%)和如厕训练(19.5%)。结论:我们的研究结果表明，儿科医生不坚持目前对儿童功能性便秘的治疗建议，因为不必要的检查被要求进行，一线治疗没有规定。

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来源期刊

Revista Paulista De Pediatria Medicine-Pediatrics, Perinatology and Child Health

CiteScore

2.30

自引率

0.00%

发文量

100

审稿时长

11 weeks

期刊介绍： The Revista Paulista de Pediatria publishes original contributions, case reports and review of clinical research with methodological approach in the areas of health and disease of neonates, infants, children and adolescents. The objective is to disseminate research with methodological quality on issues that comprise the health of children and adolescents. All articles are freely available online, via SciELO. Its abbreviated title is Rev. Paul. Pediatr., which should be used in bibliographies, footnotes and bibliographical references and strips.