Therapy for Pediatric Constipation by Practitioners : Study by Questionnaire(Papers for cerebrating the Forty Aniversary of the Department of Pediatrics, Tokyo Women\u27s Medical University Center East)

Although constipation is a common problem in childhood, the guidelines for it\u27s treatment have not been clearly established, because it is difficult to obtain clinical evaluations using the evidence-based medicine in children. The first priority we should do is to investigate the treatment of the pediatric constipation by practitioners, before the treatment protocol is considered. Subjects and methods: Sixtynine doctors who answered the questionnaire regarding the treatment of pediatric constipation among the members of Nikikai in the department of pediatrics, Tokyo Women\u27s Medical University Medical Center East and the pediatric members of the Shinjukuku Medical Association, are included in this study. Results: The abnormal stool frequency requiring the treatment is a bowel movement every 3-4 days, and the cases associated with symptoms such as hard and painful stools, according to 89% of the responding doctors. Parental education, such as dietary advice or modification of life styles is provided by 77% of the doctors. Medicine used for the constipation is most frequently glycerin enema in infants, followed by sodium picosulfate hydrate and senna. In primary-school children sodium picosulfate hydrate is used most frequently, then senna, while in the older children mainly senna is used. In conclusion, the results of this study indicated that the most frequently used medicine for pediatric constipation by practitioners is stimulant laxatives. They tend to use this medicine as the first choice because it is easily acceptable and effective for temporary episodes of constipation. Prolonged use of stimulant laxatives is not recommended. Therefore, in the cases of intractable or chronic constipation this treatment should be reconsidered.東京女子医科大学東医療センター小児科開局40周年記念論文