The impact of constipation on pediatric emergency department: a retrospective analysis of the diagnosis and management

The impact of constipation on pediatric emergency department: a retrospective analysis of the diagnosis and management

Authors

  • Antonio Gatto Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy https://orcid.org/0000-0002-8778-9328
  • Antonietta Curatola Institute of Pediatrics, Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Rome, Italy https://orcid.org/0000-0002-2430-9876
  • Serena Ferretti Institute of Pediatrics, Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Rome, Italy https://orcid.org/0000-0001-6479-1540
  • Lavinia Capossela Institute of Pediatrics, Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica Sacro Cuore, Rome, Italy
  • Lorenzo Nanni Division of Pediatric Surgery, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
  • Claudia Rendeli Spina Bifida Center, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  • Antonio Chiaretti a:1:{s:5:"en_US";s:81:"Fondazione Policlinico Gemelli IRCCS - Università Cattolica del Sacro Cuore ROMA";}

Keywords:

Children, Constipation, Emergency medicine, Health Care, Personalized medicine

Abstract

Background and aim: Functional constipation (FC) represents 95% of pediatric constipation cases. The aim of this study was to assess the prevalence of Functional Constipation in children admitted to Pediatric Emergency Department (ED) with acute abdominal pain, the demographic factors associated, the use of imaging exams and laboratory tests.

Methods: A retrospective observational study was conducted on 4100 medical records of children aged 0 to 18 years.

Results: Among children with abdominal pain, 11.3% of them had a discharge diagnosis of constipation and 45.5% underwent imaging exams. Most of children (93.9%) were discharged with home therapy and 6.5% of patients needed of additional visits. In ED 6.7% of patients underwent enema, 45.2% were discharged with indication to perform it at home.

Conclusions: FC is a medical condition that could be managed in the outpatient setting, even if we observed a significant percentage of cases in ED. We observed over-utilization of radiologic tests, whereas the diagnosis should be clinical.

References

1. Rajindrajith S, Devanarayana NM. Constipation in children: novel insight into epidemiology, pathophysiology and management. J Neurogastroenterol Motil. 2011;17:35-47
2. Van Den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol. 2006;101:2401-9
3. Xinias I, Mavroudi A. Constipation in Childhood. An update on evaluation and management. Hippokratia. 2015;19:11-9
4. Rao SS. Constipation: evaluation and treatment. Gastroenterol Clin North Am. 2003;32:659–83
5. Beckmann KR, Hennes H, Sty JR, C M Walsh-Kelly. Accuracy of clinical variables in the identification of radiographically proven constipation in children. WMJ. 2001;100:33–6
6. El-Sonbaty MM, Fathy A, Aljohani A, Fathy A. Assessment of Behavioural Disorders in Children with Functional Constipation. Open Access Maced J Med Sci. 2019;7:4019-4022
7. Caperell K, Pitetti R, Cross KP. Race and acute abdominal pain in a pediatric emergency department. Pediatrics. 2013;131:1098–106.
8. Christensen EW, Kharbanda AB, Vander Velden H, Payne NR. Predicting frequent emergency department use by pediatric Medicaid patients. Popul Health Manag. 2016;20:208–215.
9. Neuman MI, Alpern ER, Hall M, et al. Characteristics of recurrent utilization in pediatric emergency departments. Pediatrics. 2014;134:e1025–e1031
10. Kroner EL, Hoffmann RG, Brousseau DC. Emergency department reliance: a discriminatory measure of frequent emergency department users. Pediatrics. 2010;125:133–138
11. MacGeorge CA, Simpson KN, Basco WTJ, Bundy DG. Constipation-Related Emergency Department Use, and Associated Office Visits and Payments Among Commercially Insured Children. Acad Pediatr. 2018;18: 952–956
12. Stephens JR, Steiner MJ, DeJong N, et al. Healthcare utilization and spending for constipation in children with versus without complex chronic conditions. J Pediatr Gastroenterol Nutr. 2017;64:31–36
13. Liem O, Harman J, Benninga M, Kelleher K, Mousa H, Di Lorenzo C. Health utilization and cost impact of childhood constipation in the United States. J Pediatr. 2009;154:258-62
14. Goh J, Byrne PJ, McDonald G, Stephens R, Keeling P. Severe juvenile chronic constipation. Ir Med J. 2001;94:81–2
15. Dawson P, Griffith K, Boeke K. Combined medical and psychological treatment for hospitalized children with encopresis. Child Psychiatry Hum Dev.1990;20:181–9
16. Streeter BL. Teenage constipation: case study. Gastroenterol Nurs. 2002;25:253–6
17. Chiaretti A, Pierri F, Valentini P, Russo I, Gargiullo L, Riccardi R. Current practice and recent advances in pediatric pain management. Eur Rev Med Pharmacol Sci. 2013;17 Suppl 1:112-126

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Published

19-01-2022

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Section

ORIGINAL ARTICLES

How to Cite

1.
Gatto A, Curatola A, Ferretti S, Capossela L, Nanni L, Rendeli C, et al. The impact of constipation on pediatric emergency department: a retrospective analysis of the diagnosis and management. Acta Biomed [Internet]. 2022 Jan. 19 [cited 2024 Jul. 13];92(6):e2021341. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/11212