Vieira Mario C, Negrelle Isadora Carolina Krueger, Webber Karla Ulaf, Gosdal Marjorie, Truppel Sabine Krüger, Kusma Solena Ziemer
Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil; Hospital Pequeno Príncipe, Curitiba, PR, Brasil.
Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil.
Rev Paul Pediatr. 2016 Dec;34(4):425-431. doi: 10.1016/j.rpped.2016.05.003. Epub 2016 Jun 17.
To evaluate the pediatrician's knowledge regarding the diagnostic and therapeutic approach of childhood functional constipation.
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.
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.
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.
评估儿科医生对儿童功能性便秘诊断和治疗方法的了解程度。
开展一项描述性横断面研究，对2013年巴西第36届儿科学会大会上随机访谈的医生（n = 297）应用一份关于儿童功能性便秘伴大便失禁的假设临床病例的自填式问卷。
大多数参与者为女性，平均年龄为44.1岁，平均专业执业时间为18.8年；56.9%获得巴西儿科学会认证。40.4%的医生安排了额外检查；包括腹部X光检查（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%）和氧化镁乳剂（5.4%）。还给出了营养指导（84.8%）、粪便清除（17.2%）和排便训练（19.5%）。
我们的结果表明，儿科医生未遵循当前儿童功能性便秘管理的建议，因为安排了不必要的检查且未开出一线治疗药物。
