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| 1 | Pediatricians lack knowledge for the diagnosis and management of functional constipation in children over 6 mo of age显示文摘AIM To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation.METHODS A comprehensive questionnaire was distributed to general pediatricians from several teaching hospitals and government hospitals all over Indonesia.RESULTS Data were obtained from 100 pediatricians, with a mean of 78.34 ± 18.00 mo clinical practice, from 20 cities throughout Indonesia. Suspicion of constipation in a child over 6 mo of age arises when the child presents with a decreased frequency of bowel movements(according to 87% of participants) with a mean of one bowel movement per 3.59 ± 1.0 d, hard stools(83%), blood in the stools(36%), fecal incontinence(33%), and/or difficulty in defecating(47%). Only 26 pediatricians prescribe pharmacologic treatment as first therapeutic approach, while the vast majority prefers nonpharmacologic treatment, mostly(according to 68%) The preferred nonpharmacologic treatment are high-fiber diet(96%), increased fluid intake(90%), toilet training(74%), and abdominal massage(49%). Duration of non-pharmacological treatment was limited to 1 to 2 wk. Seventy percent of the pediatricians recommending toilet training could only mention some elements of the technique, and only 15% was able to explain it fully and correctly. Lactulose is the most frequent pharmacologic intervention used(87% of the participants), and rectal treatment with sodium citrate, sodium lauryl sulfo acetate, and sorbitol is the most frequent rectal treatment(85%). Only 51% will prescribe rectal treatment for fecal impaction. The majority of the pediatricians(69%) expect a positive response during the first week with a mean(± SD) of 4.1(± 2.56) d. Most participants(86%) treat during one month or even less. And the majority(67%) stops treatment when the frequency and/or consistency of the stools have become normal, or if the patient had no longer complaints.CONCLUSION These data provide an insight on the diagnosis and management of constipation in childhood in Indonesia. Although general pediatricians are aware of some important aspects of the diagnosis and mangement of constipation, overall knowledge is limited. Efforts should be made to improve the distribution of existing guidelines. These findings highlight and confirm the difficulties in spreading existing information from guidelines to general pediatricians. | Ariani Widodo Badriul Hegar Yvan Vandenplas | 2018 | World Journal of Clinical Pediatrics2018，7，1： | 6 |
| 2 | Gastroesophageal reflux : natural evolution, diagnostic approach and treatment显示文摘 | Hegar B Vandenplas Y | 2013 | Turk J Pediatr2013，55，1： | 1 |
| 3 | Gastroesophageal reflux: natural evolution,diagnostic approach and treatment 显示文摘 | Hegar B Vandenplas Y | 2013 | Turk J Pediatr2013，55，1： | 1 |
| 4 | Reduction of severe hypoglycemia by functional insulin therapy of type I diabetes mellitus显示文摘 | Hegar KE Schachinger H Berger W | | 0，，1994： | 1 |
| 5 | Gastroesophageal reflux:natural evolution,diagnostic approach and treatment显示文摘 | Hegar B Vandenplas Y | 2013 | Turk J Pediatr2013，55，1： | 1 |
| 6 | Randomized controlled clinical of blood glucose awareness training(BGAT Ⅲ) in Switzerland and Germany显示文摘 | Schachinger H Hegar K Hermanns N | 2005 | Journal of Behavior Medicine2005，28，6： | 1 |
| 7 | Gastroesophageal reflux: natural evolution, diagnostic approach and treatment显示文摘 | Hegar B Vandenplas Y | 2013 | Turk J Pediatr2013，55，1： | 1 |
| 8 | Natural evolution of regurgitation in healthy infants 显示文摘 | Hegar B Dewanti NR Kadim M | 2009 | Acta Paediatr2009，98，7： | 1 |
| 9 | Gastroesophageal reflux: natural evo- lution, diagnostic approach and treatment 显示文摘 | Hegar B Vandenplas Y | 2013 | Turk J Pediatr2013，55，1： | 1 |
| 10 | Carbohydrate counting of food 显示文摘 | Hegar K Heiber S Brgmdle M | 2011 | Swiss Med Wkly2011，，13： | 1 |
| 11 | Naatural evolution of regurgitation in healthy infants 显示文摘 | Hegar B Dewanti N R Kadim M | 2009 | Acta Paediatr2009，98，7： | 1 |
| 12 | Natural evolution of regurgi- tation in healthy infants 显示文摘 | Hegar B Dewanti NR Kadim M | 2009 | Acta Paediatr2009，98，7： | 1 |
| 13 | Appearance of the hymen in prepubertal girls显示文摘 | Hegar AH Hayes TM | 1993 | Pediatrics1993，89，： | 1 |
| 14 | Rduction of severe hypoglycemia by functional insulin therapy of type 1 diabetes mellitus显示文摘 | Hegar KE Schachinger H Berger W | 2002 | Prsxis2002，91，3： | 1 |
| 15 | A double-blind placebo-controlled randomized trial on probiotics in small bowel bacterial overgrowth in children treated with omeprazole 显示文摘 | Hegar B Hutapea EI Advani N | 2013 | J Pediatr ( Rio J )2013，89，4： | 1 |
| 16 | Gastroesophageal reflux in infants显示文摘 | Hegar B | 2014 | Southeast Asian J Trop Med Public Health2014，45，1： | 1 |
| 17 | Regurgitation and gastroe- sophageal reflux disease in six to nine months old indonesian infants 显示文摘 | Hegar B Satari DH Sjarif DR | 2013 | Pediatr Gastroenterol Hepatol Nutr2013，16，4： | 1 |
| 18 | Gastroesophageal reflux : natural evolution, diag- nostic approach and treatment显示文摘 | Hegar B Vandenplas Y | 2013 | Turk J Pediatr2013，55，1： | 1 |
| 19 | Prevalence and Health Outcomes of Functional Gastrointestinal Symptoms in Infants From Birth to 12 Months of Age显示文摘 | Yvan Vandenplas Abdelhak Abkari Marc Bellaiche Marc Benninga Jean Pierre Chouraqui Fügen?ullu ?okura Tracy Harb Badriul Hegar Carlos Lifschitz Thomas Ludwig Mohamed Miqdady Mauro Batista de Morais Seksit Osatakul Silvia Salvatore Raanan Shamir Annamaria S | 2015 | Journal of Pediatric Gastroenterology and Nutriti2015，，5： | 1 |
| 20 | Natural evolution of regurgitation in healthy infants显示文摘 | Hegar B Dewanti NR Kadim M | 2009 | Acta Paediatr2009，98，7： | 1 |
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