Evidence-Based Interventions to Manage Chronic Constipation in Children
Anna Marie McMillan
Frontier Nursing University
Abstract
Constipation accounts for approximately 3% of pediatrician visits and about 10-25% of referrals of pediatric gastroenterologist. Rome III criteria is utilized in the study to determine eligible participants. Organic constipation is related to a physiological cause, patients suffering from organic constipation were not included in the study. Patients with functional/idiopathic constipation were utilized. Contributing factors are discussed as well as pharmacological and non-pharmacological treatments. With various options available to manage chronic constipation polyethylene glycol (PEG) is compared …show more content…
According to Russell, Barnhart, Zobell, Scaife, & Rollins (2015), “children must have at least 2 of the following symptoms per week: a maximum of 2 stools, an episode of incontinence, volitional stool retention, painful stools, large diameter stools, or a large fecal mass in the rectum” (para. 1).
Types of Constipation
Functional Constipation
Functional constipation is often idiopathic, maybe related to change in diet or fluid intake, or modification in physical activity. Functional constipation can also transpire when a child experiences an altered routine or involved in a traumatic life event.
Organic Constipation
Organic constipation can be related to physiological origins such as Hirschsprung’s disease, pseudo-obstruction, neural causes (i.e., spinal cord abnormality), metabolic or endocrine disorders (i.e., hypothyroidism, diabetes insipidus), cystic fibrosis, gluten or congenital anorectal malformations. In the studies reviewed those with organic causes were excluded.
Contributing Factors to …show more content…
Also, no blood on the stool from anal fissures. As well as, decreasing ER visits and invasive treatments.
Non-pharmacological Treatments
Non-pharmacological treatments often decrease the severity of the constipation.
• Dehydration can affect the severity of constipation. The decrease fluid in the body can result in insufficient fluid in the colon, therefore causing dry, hard, painful stools.
• Regular physical activity will increase intestinal motility which decreases the time the stool resides in the colon and decrease absorption of fluid from the stool.
• Provide high fiber diet.
• Evaluate constipation is not a side effect from current medications child may be taking.
• Set time for child to sit on toilet, with a stool if needed. Allow time for child to relax and have a bowel moment. The appropriate time will vary depending on maturity.
• Provide positive feedback with success.
Pharmacological
Anna Marie McMillan
Frontier Nursing University
Abstract
Constipation accounts for approximately 3% of pediatrician visits and about 10-25% of referrals of pediatric gastroenterologist. Rome III criteria is utilized in the study to determine eligible participants. Organic constipation is related to a physiological cause, patients suffering from organic constipation were not included in the study. Patients with functional/idiopathic constipation were utilized. Contributing factors are discussed as well as pharmacological and non-pharmacological treatments. With various options available to manage chronic constipation polyethylene glycol (PEG) is compared …show more content…
According to Russell, Barnhart, Zobell, Scaife, & Rollins (2015), “children must have at least 2 of the following symptoms per week: a maximum of 2 stools, an episode of incontinence, volitional stool retention, painful stools, large diameter stools, or a large fecal mass in the rectum” (para. 1).
Types of Constipation
Functional Constipation
Functional constipation is often idiopathic, maybe related to change in diet or fluid intake, or modification in physical activity. Functional constipation can also transpire when a child experiences an altered routine or involved in a traumatic life event.
Organic Constipation
Organic constipation can be related to physiological origins such as Hirschsprung’s disease, pseudo-obstruction, neural causes (i.e., spinal cord abnormality), metabolic or endocrine disorders (i.e., hypothyroidism, diabetes insipidus), cystic fibrosis, gluten or congenital anorectal malformations. In the studies reviewed those with organic causes were excluded.
Contributing Factors to …show more content…
Also, no blood on the stool from anal fissures. As well as, decreasing ER visits and invasive treatments.
Non-pharmacological Treatments
Non-pharmacological treatments often decrease the severity of the constipation.
• Dehydration can affect the severity of constipation. The decrease fluid in the body can result in insufficient fluid in the colon, therefore causing dry, hard, painful stools.
• Regular physical activity will increase intestinal motility which decreases the time the stool resides in the colon and decrease absorption of fluid from the stool.
• Provide high fiber diet.
• Evaluate constipation is not a side effect from current medications child may be taking.
• Set time for child to sit on toilet, with a stool if needed. Allow time for child to relax and have a bowel moment. The appropriate time will vary depending on maturity.
• Provide positive feedback with success.
Pharmacological