Incidence, clinical presentation, and management of constipation in a pediatric ED

Abstract Objectives 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. Design This is a retrospective study of hospital re...

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Published in:The American journal of emergency medicine 2010-02, Vol.28 (2), p.189-194
Main Authors: Diamanti, Antonella, MD, Bracci, Fiammetta, PhD, Reale, Antonino, MD, Crisogianni, Massimo, MD, Pisani, Mara, MD, Castro, Massimo, MD
Format: Article
Language:English
Subjects:
Abdomen
Adolescent
Age Distribution
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Child
Child, Preschool
Confidence intervals
Constipation
Constipation - diagnosis
Constipation - epidemiology
Constipation - therapy
Continuity of Patient Care
Emergency
Emergency and intensive care: neonates and children. Prematurity. Sudden death
Emergency medical care
Emergency medical services
Emergency Service, Hospital - statistics & numerical data
Family medical history
Female
Hospitalization
Hospitals
Humans
Incidence
Infant
Infant, Newborn
Intensive care medicine
Intervention
Male
Medical History Taking
Medical sciences
Physical Examination
Physicians
Retrospective Studies
Rome - epidemiology
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cited_by cdi_FETCH-LOGICAL-c468t-76e1a4942c6a9c9298dee177a6373114c6a3f121675eba34ec514940e81584313
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container_start_page 189
container_title The American journal of emergency medicine
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creator Diamanti, Antonella, MD
Bracci, Fiammetta, PhD
Reale, Antonino, MD
Crisogianni, Massimo, MD
Pisani, Mara, MD
Castro, Massimo, MD
description Abstract Objectives 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. Design 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. Interventions We analyzed medical records of 202 patients (
doi_str_mv 10.1016/j.ajem.2008.11.016
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Design 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. Interventions We analyzed medical records of 202 patients (&lt;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 &lt; .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 &lt; .0001). The number of patients beginning a therapy after ED discharge was significantly higher compared with that already treated before ED visit ( P &lt; .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.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2008.11.016</identifier><identifier>PMID: 20159389</identifier><identifier>CODEN: AJEMEN</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Abdomen ; Adolescent ; Age Distribution ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Child ; Child, Preschool ; Confidence intervals ; Constipation ; Constipation - diagnosis ; Constipation - epidemiology ; Constipation - therapy ; Continuity of Patient Care ; Emergency ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Emergency medical care ; Emergency medical services ; Emergency Service, Hospital - statistics &amp; numerical data ; Family medical history ; Female ; Hospitalization ; Hospitals ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive care medicine ; Intervention ; Male ; Medical History Taking ; Medical sciences ; Physical Examination ; Physicians ; Retrospective Studies ; Rome - epidemiology</subject><ispartof>The American journal of emergency medicine, 2010-02, Vol.28 (2), p.189-194</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-76e1a4942c6a9c9298dee177a6373114c6a3f121675eba34ec514940e81584313</citedby><cites>FETCH-LOGICAL-c468t-76e1a4942c6a9c9298dee177a6373114c6a3f121675eba34ec514940e81584313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=22560963$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20159389$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Diamanti, Antonella, MD</creatorcontrib><creatorcontrib>Bracci, Fiammetta, PhD</creatorcontrib><creatorcontrib>Reale, Antonino, MD</creatorcontrib><creatorcontrib>Crisogianni, Massimo, MD</creatorcontrib><creatorcontrib>Pisani, Mara, MD</creatorcontrib><creatorcontrib>Castro, Massimo, MD</creatorcontrib><title>Incidence, clinical presentation, and management of constipation in a pediatric ED</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Abstract Objectives 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. Design 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. Interventions We analyzed medical records of 202 patients (&lt;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 &lt; .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 &lt; .0001). The number of patients beginning a therapy after ED discharge was significantly higher compared with that already treated before ED visit ( P &lt; .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.</description><subject>Abdomen</subject><subject>Adolescent</subject><subject>Age Distribution</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Confidence intervals</subject><subject>Constipation</subject><subject>Constipation - diagnosis</subject><subject>Constipation - epidemiology</subject><subject>Constipation - therapy</subject><subject>Continuity of Patient Care</subject><subject>Emergency</subject><subject>Emergency and intensive care: neonates and children. Prematurity. 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Design 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. Interventions We analyzed medical records of 202 patients (&lt;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 &lt; .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 &lt; .0001). The number of patients beginning a therapy after ED discharge was significantly higher compared with that already treated before ED visit ( P &lt; .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.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20159389</pmid><doi>10.1016/j.ajem.2008.11.016</doi><tpages>6</tpages></addata></record>
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ispartof The American journal of emergency medicine, 2010-02, Vol.28 (2), p.189-194
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source Elsevier
subjects Abdomen
Adolescent
Age Distribution
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Child
Child, Preschool
Confidence intervals
Constipation
Constipation - diagnosis
Constipation - epidemiology
Constipation - therapy
Continuity of Patient Care
Emergency
Emergency and intensive care: neonates and children. Prematurity. Sudden death
Emergency medical care
Emergency medical services
Emergency Service, Hospital - statistics & numerical data
Family medical history
Female
Hospitalization
Hospitals
Humans
Incidence
Infant
Infant, Newborn
Intensive care medicine
Intervention
Male
Medical History Taking
Medical sciences
Physical Examination
Physicians
Retrospective Studies
Rome - epidemiology
title Incidence, clinical presentation, and management of constipation in a pediatric ED
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