Rome IV Clinical Criteria and Management of Functional Constipation: Indonesian Health Care Professionals’ Perspective
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The updated ROME IV criteria for functional constipation (FC) in children were published in 2016. However, information on the use of these criteria is scarce. This study aimed to report the frequency of the use of the ROME IV criteria by Indonesian pediatricians and general practitioners (GPs) in FC management in infants and toddlers. Methods: An anonymous cross-sectional online survey was conducted between November 2021 and March 2022. Results: A total of 248 respondents (183 pediatricians and 65 GPs) from 24 Indonesian provinces completed the survey. Most respondents reported an estimated prevalence of FC to be less than 5% both in infants and toddlers. On average, only 64.6% of respondents frequently used the ROME IV criteria. Pediatricians used the ROME IV criteria more often than GPs did (p<0.001). The most frequently used criteria were painful or hard bowel movements (75.0%) and ≤2 defecations/week (71.4%). Lactulose as a laxative was the preferred treatment choice, followed by changing the standard formula to a specific nutritional formula. Most of the respondents carried out parenteral reassurance and education. Normal growth, as a marker of good digestion and absorption function, and normal stool consistency and frequency were the most reported indicators of gut health. Conclusion: The ROME IV criteria for functional constipation are not extensively used by pediatricians and GPs in Indonesia. Laxatives and specific nutritional formulas were the most used management approaches in infants and toddlers. Medical education, especially for general practitioners, should be updated.
Abstract
Purpose: The updated ROME IV criteria for functional constipation (FC) in children were published in 2016. However, information on the use of these criteria is scarce. This study aimed to report the frequency of the use of the ROME IV criteria by Indonesian pediatricians and general practitioners (GPs) in FC management in infants and toddlers. Methods: An anonymous cross-sectional online survey was conducted between November 2021 and March 2022. Results: A total of 248 respondents (183 pediatricians and 65 GPs) from 24 Indonesian provinces completed the survey. Most respondents reported an estimated prevalence of FC to be less than 5% both in infants and toddlers. On average, only 64.6% of respondents frequently used the ROME IV criteria. Pediatricians used the ROME IV criteria more often than GPs did (p<0.001). The most frequently used criteria were painful or hard bowel movements (75.0%) and ≤2 defecations/week (71.4%). Lactulose as a laxative was the preferred treatment choice, followed by changing the standard formula to a specific nutritional formula. Most of the respondents carried out parenteral reassurance and education. Normal growth, as a marker of good digestion and absorption function, and normal stool consistency and frequency were the most reported indicators of gut health. Conclusion: The ROME IV criteria for functional constipation are not extensively used by pediatricians and GPs in Indonesia. Laxatives and specific nutritional formulas were the most used management approaches in infants and toddlers. Medical education, especially for general practitioners, should be updated.
참고문헌 (32)
- Rajindrajith S, "Childhood constipation as an emerging public health problem", World J Gastroenterol, 22, pp.6864~6875 (2016)
- Mugie SM, "Epidemiology of constipation in children and adults : a systematic review", Best Pract Res Clin Gastroenterol, 25, pp.3~18 (2011)
- Hasosah M, "Knowledge and practice styles of pediatricians in Saudi Arabia regarding childhood constipation", J Pediatr Gastroenterol Nutr, 57, pp.85~92 (2013)
- Borowitz SM, "Treatment of childhood constipation by primary care physicians : efficacy and predictors of outcome", Pediatrics, 115, pp.873~877 (2005)
- Burgers R, "The care of constipated children in primary care in different countries", Acta Paediatr, 101, pp.677~680 (2012)
- Singh H, "Paediatric Constipation : An approach and evidence-based treatment regimen", Aust J Gen Pract, 47, pp.273~277 (2018)
- Nutter A, "Constipation and paediatric emergency department utilization", Paediatr Child Health, 22, pp.139~142 (2017)
- Koppen IJN, "Prevalence of functional defecation disorders in children: a systematic review and meta-analysis", J Pediatr, 198, pp.121~130 (2018)
- Muhardi L, "A narrative review on the update in the prevalence of infantile colic, regurgitation, and constipation in young children : implications of the ROME IV criteria", Front Pediatr, 9, pp.1~9 (2022)
- Oswari H, "Epidemiology of Paediatric constipation in Indonesia and its association with exposure to stressful life events", BMC Gastroenterol, 18, pp.1~8 (2018)
- West LN, "Reported prevalence and nutritional management of functional constipation among young children from healthcare professionals in eight countries across Asia, Europe and Latin America", Nutrients, 14, pp.1~19 (2022)
- Jang HJ, "Nationwide survey for application of ROME IV criteria and clinical practice for functional constipation in children", J Korean Med Sci, 34, pp.1~11 (2019)
- Torres MRF, "Knowledge and practices of pediatricians regarding functional constipation in the state of Minas Gerais, Brazil", J Pediatr Gastroenterol Nutr, 61, pp.74~79 (2015)
- Scarpato E, "Functional gastrointestinal disorders in children : a survey on clinical approach in the mediterranean area", J Pediatr Gastroenterol Nutr, 64, pp.e142~6 (2017)
- Christian BM, "OP-22 Perceptions and Knowledge About Constipation in Argentine Pediatricians. Results of A Preliminary Survey", Paper presented at: VII European Gastrointestinal Pediatric Motility Meeting, pp.525~ (2015)
- Schmulson M, "A four-country comparison of healthcare systems, implementation of diagnostic criteria, and treatment availability for functional gastrointestinal disorders : a report of the Rome Foundation Working Team on cross-cultural, multinational research", Neurogastroenterol Motil, 26, pp.1368~1385 (2014)
- Malowitz S, "Age of onset of functional constipation", J Pediatr Gastroenterol Nutr, 62, pp.600~602 (2016)
- Turco R, "Early-life factors associated with pediatric functional constipation", J Pediatr Gastroenterol Nutr, 58, pp.307~312 (2014)
- Benninga MA, "Childhood constipation : is there new light in the tunnel?", J Pediatr Gastroenterol Nutr, 39, pp.448~464 (2004)
- Borowitz SM, "Precipitants of constipation during early childhood", J Am Board Fam Pract, 16, pp.213~218 (2003)
- Widodo A, "Pediatricians lack knowledge for the diagnosis and management of functional constipation in children over 6 mo of age", World J Clin Pediatr, 7, pp.56~61 (2018)
- National Institute for Health and Care Excellence (NICE), "National Institute for Health and Care Excellence: Guidelines" (2010), RCOG Press
- Tabbers MM, "Evaluation and treatment of functional constipation in infants and children : evidence-based recommendations from ESPGHAN and NASPGHAN", J Pediatr Gastroenterol Nutr, 58, pp.258~274 (2014)
- Vandenplas Y, "Functional gastrointestinal disorder algorithms focus on early recognition, parental reassurance and nutritional strategies", Acta Paediatr, 105, pp.244~252 (2016)
- Rajindrajith S, "Constipation in children : novel insight into epidemiology, pathophysiology and management", J Neurogastroenterol Motil, 17, pp.35~47 (2011)
- Sekkidou M, "Nutritional management with a casein-based extensively hydrolysed formula in infants with clinical manifestations of non-IgE-mediated CMPA enteropathies and constipation", Front Allergy, 2, pp.676075~ (2021)
- Koletzko S, "Diagnostic approach and management of cow’s-milk protein allergy in infants and children : ESPGHAN GI Committee practical guidelines", J Pediatr Gastroenterol Nutr, 55, pp.221~229 (2012)
- Pensabene L, "Cow’s milk protein allergy in infancy : a risk factor for functional gastrointestinal disorders in children?", Nutrients, 10, pp.1716~ (2018)
- Vandenplas Y, "An ESPGHAN position paper on the diagnosis, management and prevention of cow’s milk allergy", J Pediatr Gastroenterol Nutr (2023)
- de Mello PP, "Use of fibers in childhood constipation treatment : systematic review with meta-analysis", J Pediatr(Rio J), 94, pp.460~470 (2018)
- Goodman BE, "Insights into digestion and absorption of major nutrients in humans", Adv Physiol Educ, 34, pp.44~53 (2010)
- "Malabsorption Syndromes" (2022)[URL]