Guideline for the management of pediatric idiopathic constipation and soiling. Multidisciplinary team from the University of Michigan Medical Center in Ann Arbor.
OBJECTIVE
To develop an evidence-based guideline for the primary pediatric care of children (birth to 18 years old) with idiopathic constipation and soiling.


METHODS
References were identified through a MEDLINE search from January 1975 through January 1998 to address 3 focus questions: (1) the best path to early, accurate diagnosis; (2) best methods for adequate clean-out; and (3) best approaches to promote patient and family compliance with management.


METHODS
Twenty-five references were identified.


METHODS
References were reviewed by a multidisciplinary team and graded according to the following criteria: randomized controlled trial; controlled trial, no randomization; observational study; and expert opinion. Evidence tables were developed for each focus question.


RESULTS
An algorithm and clinical care guideline were developed by consultation and consensus among team members. Emphasis was placed on methods to promote early identification of pediatric idiopathic constipation and soiling, to recognize points of referral, and to increase patient and family compliance with treatment through use of education, developmentally based interventions, and variables for tracking success of management.


CONCLUSIONS
An algorithm and guideline for pediatric idiopathic constipation and soiling are presented for use by primary care physicians.
Felt
B
B
Division of General Academic Pediatrics, University of Michigan School of Medicine, Ann Arbor 48109-0406, USA. truefelt@umich.edu
Wise
C G
CG
Olson
A
A
Kochhar
P
P
Marcus
S
S
Coran
A
A
D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D018849:Controlled Clinical Trials as Topic; D003937:Diagnosis, Differential; D005242:Fecal Incontinence / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D015995:Prevalence; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic