title: Pediatrician's knowledge on the approach of functional constipation.
abstract: OBJECTIVE
  To evaluate the pediatrician's knowledge regarding the diagnostic and therapeutic approach of childhood functional constipation.
  
  
  METHODS
  A descriptive cross-sectional study was performed with the application of a self-administered questionnaire concerning a hypothetical clinical case of childhood functional constipation with fecal incontinence to physicians (n=297) randomly interviewed at the 36th Brazilian Congress of Pediatrics in 2013.
  
  
  RESULTS
  The majority of the participants were females, the mean age was 44.1 years, the mean time of professional practice was 18.8 years; 56.9% were Board Certified by the Brazilian Society of Pediatrics. Additional tests were ordered by 40.4%; including abdominal radiography (19.5%), barium enema (10.4%), laboratory tests (9.8%), abdominal ultrasound (6.7%), colonoscopy (2.4%), manometry and rectal biopsy (both 1.7%). The most common interventions included lactulose (26.6%), mineral oil (17.5%), polyethylene glycol (14.5%), fiber supplement (9.1%) and milk of magnesia (5.4%). Nutritional guidance (84.8%), fecal disimpaction (17.2%) and toilet training (19.5%) were also indicated.
  
  
  CONCLUSIONS
  Our results show that pediatricians do not adhere to current recommendations for the management of childhood functional constipation, as unnecessary tests were ordered and the first-line treatment was not prescribed.
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil; Hospital Pequeno Príncipe, Curitiba, PR, Brasil.
authors.forename: Mario C
authors.initials: MC
authors.lastname: Vieira
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil.
authors.forename: Isadora Carolina Krueger
authors.initials: IC
authors.lastname: Negrelle
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil.
authors.forename: Karla Ulaf
authors.initials: KU
authors.lastname: Webber
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil. Electronic address: marjorie.gosdal@hotmail.com.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Gosdal
authors.affiliation: Hospital Pequeno Príncipe, Curitiba, PR, Brasil.
authors.forename: Sabine Krüger
authors.initials: SK
authors.lastname: Truppel
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil.
authors.forename: Solena Ziemer
authors.initials: SZ
authors.lastname: Kusma
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D002983:Clinical Competence; D003248:Constipation / Q000175:diagnosis* / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010372:Pediatrics; D057566:Self Report
keywords: Constipation; Constipação intestinal; Diagnostic; Diagnóstico; Pediatria; Pediatrics; Tratamento; Treatment