Practice Guideline Endorsement

Constipation in Infants and Children: Evaluation and Treatment

The American Academy of Pediatrics endorses and accepts as its policy the North American Society for Pediatric Gastroenterology and Nutrition Position Statement, "Constipation in Infants and Children: Evaluation and Treatment."

Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

ABSTRACT
Constipation, defined as a delay or difficulty in defecation, present for 2 or more weeks, is a common pediatric problem encountered by both primary and specialty medical providers.

The Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) has formulated a clinical practice guideline for the management of pediatric constipation. The Constipation Guideline Committee, consisting of 2 primary care pediatricians, 1 clinical epidemiologist, and pediatric gastroenterologists, based its recommendations on an integration of a comprehensive and systematic review of the medical literature combined with expert opinion.

Consensus was achieved through nominal group technique, a structured quantitative method. The Committee developed 2 algorithms to assist with medical management, 1 for older infants and children and the second for infants less than 1 year of age. The guideline provides recommendations for management by the primary care provider, including evaluation, initial treatment, follow-up management, and indications for consultation by a specialist.

The Constipation Guideline Committee also provided recommendations for management by the pediatric gastroenterologist.

The Guidelines are available as a PDF file from the NASPGN Web site free-of-charge at: http://www.naspghan.org/PDF/PositionPapers/constipation.guideline.2006.pdf

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The recommendations in this statement do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.

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