Incidence, clinical presentation, and management of constipation in a pediatric ED.
OBJECTIVE
The study aimed to assess, in pediatric patients presenting to the emergency department (ED), the incidence of visit to the ED for functional constipation (FC), symptoms, signs of presentation, and management from ED physicians.


METHODS
This is a retrospective study of hospital records for a period of 1 year at the ED of "Bambino Gesù" Children's Hospital, Rome, Italy. Children younger than 15 years discharged from ED with a diagnosis of FC in the 1-year period were included.


METHODS
We analyzed medical records of 202 patients (<15 years) with FC diagnosis at discharge. Main outcome measures included incidence, demographic characteristics, clinical presentations of FC patients, and ED physicians' interventions.


RESULTS
Two hundred two FC cases were studied in a 12-month study period. Compared with the total number of ED consultations, the incidence of FC was 0.4%. The number of patients 4 years or younger was much higher than patients older than 4 years (P < .0001). Bowel frequency of 3 bowel movements or less per day, acute abdominal pain, and stool retention were found to be significantly more frequent than the other presenting symptoms (P < .0001). The number of patients beginning a therapy after ED discharge was significantly higher compared with that already treated before ED visit (P < .0001). Discharged patients were referred to community pediatricians significantly more frequently than to pediatric gastroenterologists (P = .003).


CONCLUSIONS
Emergency department physicians have an important role in the diagnosis and management of FC despite its relatively low incidence. Indeed, ED intervention in many cases leads not only to recognition this disease but also to an approach for therapeutic strategy, avoiding complications of chronic constipation.
Gastroenterology and Nutrition Unit, "Bambino Gesù" Children's Hospital, 00165 Rome, Italy.
Antonella
A
Diamanti
Fiammetta
F
Bracci
Antonino
A
Reale
Massimo
M
Crisogianni
Mara
M
Pisani
Massimo
M
Castro
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003266:Continuity of Patient Care; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008487:Medical History Taking; D010808:Physical Examination; D012189:Retrospective Studies; D012384:Rome / Q000453:epidemiology