title: Knowledge and practice styles of pediatricians in Saudi Arabia regarding childhood constipation.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pediatric Gastroenterology, King Saud Bin Abdulaziz University for Health Sciences, National Guard Hospital, Jeddah, Saudi Arabia. hasosah2007@yahoo.com
authors.forename: Mohammed
authors.initials: M
authors.lastname: Hasosah
authors.forename: Abdulwahab
authors.initials: A
authors.lastname: Telmesani
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Binali
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sarkhi
authors.forename: Sharifah
authors.initials: S
authors.lastname: Alghamdi
authors.forename: Khalid
authors.initials: K
authors.lastname: Alquair
authors.forename: Moath
authors.initials: M
authors.lastname: Alturaiki
authors.forename: Aziz
authors.initials: A
authors.lastname: Alanazi
authors.forename: Ashraf
authors.initials: A
authors.lastname: Alsahafi
authors.forename: Abdullah
authors.initials: A
authors.lastname: Alzaben
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D015331:Cohort Studies; D003248:Constipation / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D005244:Fecal Impaction / Q000209:etiology / Q000517:prevention & control; D005762:Gastroenterology; D058006:General Practice; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007792:Lactulose / Q000627:therapeutic use; D054368:Laxatives / Q000627:therapeutic use; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012529:Saudi Arabia; D055502:Secondary Prevention; D000078329:Workforce
chemical_list: D054368:Laxatives; D007792:Lactulose