Baker S S, Liptak G S, Colletti R B, Croffie J M, Di Lorenzo C, Ector W, Nurko S
Department of Pediatrics, Medical University of South Carolina, Charleston, USA.
J Pediatr Gastroenterol Nutr. 1999 Nov;29(5):612-26. doi: 10.1097/00005176-199911000-00029.
Constipation, defined as a delay or difficulty in defecation, present for 2 or more weeks, is a common pediatric problem encountered by both primary and specialty medical providers.
The Constipation Subcommittee of the Clinical Guidelines Committee of the North American Society for Pediatric Gastroenterology and Nutrition has formulated clinical practice guidelines for the management of pediatric constipation. The Constipation Subcommittee, consisting of two primary care pediatricians, a clinical epidemiologist, and pediatric gastroenterologists, based its recommendations on an integration of a comprehensive and systematic review of the medical literature combined with expert opinion. Consensus was achieved through Nominal Group Technique, a structured quantitative method.
The Subcommittee developed two algorithms to assist with medical management, one for older infants and children and the second for infants less than 1 year of age. The guidelines provide recommendations for management by the primary care provider, including evaluation, initial treatment, follow-up management, and indications for consultation by a specialist. The Constipation Subcommittee also provided recommendations for management by the pediatric gastroenterologist.
This report, which has been endorsed by the Executive Council of the North American Society for Pediatric Gastroenterology and Nutrition, has been prepared as a general guideline to assist providers of medical care in the evaluation and treatment of constipation in children. It is not intended as a substitute for clinical judgment or as a protocol for the management of all patients with this problem.
便秘定义为排便延迟或困难，持续2周或更长时间，是基层医疗和专科医疗服务提供者都会遇到的常见儿科问题。
北美小儿胃肠病学与营养学会临床指南委员会便秘小组委员会制定了小儿便秘管理的临床实践指南。该便秘小组委员会由两名基层儿科医生、一名临床流行病学家和小儿胃肠病学家组成，其建议基于对医学文献的全面系统回顾并结合专家意见。通过名义小组技术（一种结构化定量方法）达成共识。
该小组委员会制定了两种算法以协助医疗管理，一种适用于较大婴儿和儿童，另一种适用于1岁以下婴儿。这些指南为基层医疗服务提供者的管理提供了建议，包括评估、初始治疗、后续管理以及专科会诊指征。便秘小组委员会还为小儿胃肠病学家的管理提供了建议。
本报告已得到北美小儿胃肠病学与营养学会执行委员会的认可，编写此报告旨在作为一般指南，协助医疗服务提供者评估和治疗儿童便秘。它并非旨在替代临床判断，也不是针对所有有此问题患者的管理方案。
