FEATURESPrimary Care Constipation and Encopresis Treatment Strategies and Reasons to ReferPhilichi, Lisa MN, ARNP; Yuwono, Melawati MDAuthor Information Lisa Philichi, MN, ARNP, is Pediatric Nurse Practitioner at Pediatric Gastroenterology Clinic, Mary Bridge Children's Health Center, Tacoma, WA. Melawati Yuwono, MD, is Gastroenterologist at Pediatric Gastroenterology Clinic, Mary Bridge Children's Health Center, Tacoma, WA. Correspondence to: Lisa Philichi, MN, ARNP, Pediatric Gastroenterology Clinic, Mary Bridge Children's Health Center, 311 SL St, Tacoma, WA 98405 (e-mail: [email protected]). Received January 8, 2010 Accepted April 17, 2010 Gastroenterology Nursing: September/October 2010 - Volume 33 - Issue 5 - p 363-366 doi: 10.1097/SGA.0b013e3181f35020 Buy Metrics Abstract The purpose of the study was to assess constipation and encopresis treatment strategies of primary care providers and determine reasons to refer to a pediatric gastroenterology specialist. A closed-ended questionnaire was mailed to a convenience sampling of 237 pediatric primary care providers. Ninety-one questionnaires were returned with a 38% response rate: 74 (81%) pediatricians and 17 (19%) nurse practitioners. The majority of responders recommended pharmacologic treatment and diet changes. Many providers (73%) estimated a 75%-100% success rate when managing constipation, whereas 19% providers estimated a greater than 80% success rate with encopresis patients. The number one reason to refer was unresponsiveness to treatment (71%), followed by parents want a second opinion (15%), rule out organic cause (9%), and management is too time-consuming (5%). Both primary care providers and pediatric gastroenterologists use medication strategies, but diet recommendations are not the same. Unresponsiveness to treatment is the main reason for referral. If better management can occur in the primary care setting, costly specialty services may be avoided and possibly reduce healthcare costs. © The Society of Gastroenterology Nurses & Associates 2010. All Rights Reserved.