Objectives: The aim of the present study was to evaluate knowledge and practice styles among medical providers working in 5 regions of Saudi Arabia regarding their approach to childhood constipation.
Methods: A survey of 850 pediatric providers (PPs) conducted in 5 regions of Saudi Arabia. PPs included pediatric specialists (PSs), pediatric consultants (PCs), general practitioners (GPs), family physicians (FPs), and pediatric gastroenterologists (PGs). They were asked anonymously about definition, causes, diagnosis, and management of constipation. Information about family concerns regarding constipation and the source of constipation-related information was also collected.
Results: A response rate of 73% yielded 622 questionnaires. Among respondents, 61.2% were aware of the Rome definition of functional constipation. More pediatricians (PSs and PCs) than other physicians (GPs and FPs) reported the definition of constipation correctly (P > 0.05). Stool withholding was reported as the most common cause of constipation by 27% of pediatricians (PSs and PCs), 24% of other physicians (GPs and FPs), and 50% of PGs (P = 0.097). Rectal examination was performed by 39% of all PPs and 78.6% of PGs (P = 0.009). Pediatricians prescribed lactulose significantly more often than physicians (P = 0.001). Pediatricians recommended disimpaction before maintenance treatment significantly more than other physicians (P = 0.001). Twenty-three percent of families believed that constipation was caused by a stricture and 10% feared it was caused by a malignancy.
Conclusions: Significant differences in knowledge and practice patterns exist regarding the approach to pediatric constipation. Identification of knowledge gaps may be useful to develop educational materials to improve proper diagnosis and treatment of childhood constipation.
*Department of Pediatric Gastroenterology, King Saud Bin Abdulaziz University for Health Sciences, National Guard Hospital, Jeddah
†Department of Pediatric Gastroenterology, Um Al-Qura University, Makkah
‡Department of Pediatric Gastroenterology, King Khalid University, Abha
§Department of Pediatric Gastroenterology, King Khalid University, Riyad
||Department of Pediatric Gastroenterology, King Faisal Specialist Hospital & Research Center, Jeddah
¶Department of Pediatric Gastroenterology, Military Hospital, Tabouk
#Department of Pediatric Gastroenterology, Prince Salman Hospital, Riyadh
**Department of Pediatric Gastroenterology, King Fahad Specialist Hospital, Dammam
††Department of Pediatric Gastroenterology, King Saud Bin Abdulaziz University for Health Sciences, National Guard Hospital, Riyadh, Saudi Arabia
‡‡Division of Pediatric Gastroenterology, Nationwide Children's Hospital, Columbus, OH.
Address correspondence and reprint requests to Dr Mohammed Hasosah, Department of Pediatric Gastroenterology, King Saud Bin Abdulaziz University for Health Sciences/National Guard Health Affairs, King Abdul-Aziz Medical City, National Guard Hospital, PO Box 8202, Jeddah 21482, Saudi Arabia (e-mail: email@example.com).
Received 5 February, 2013
Accepted 8 March, 2013
This research was funded by a grant from King Abdullah International Medical Research Center (RCJ0412-212).
The authors report no conflicts of interest.