{
  "abstract": "Why did you do this work? Constipation makes up to 25% of paediatric gastroenterology referrals and 3–5% of all paediatric referrals 1. The 2021 GAPRUKI (General and Adolescent Paediatric Research in the United Kingdom & Ireland) research prioritisation exercise identified constipation as one of 14 key research priorities2. In response to this exercise, this project aims to explore the current management of constipation among paediatric consultants and specialist nurses in secondary and tertiary care, something that has not been undertaken to date, and identify common themes in order to inform future research.What did you do? A peer-reviewed online survey was distributed to Consultant General Paediatricians, Paediatric Gastroenterologists, Community Paediatricians and Specialist Nurses managing constipation. Mailing lists from GAPRUKI, BSPHGHAN (British Society of Paediatric Gastroenterology, Hepatology and Nutrition) and BACD (British Academy of Childhood Disability) were utilised to disseminate the survey. Responses were collected via Qualtrics and analysed using Excel. Initial thematic analysis was performed using NVivo software.What did you find? 79 clinicians responded from across the UK, including 47 General Paediatricians, 11 Paediatric Gastroenterologists, 6 Community Paediatricians and 4 Specialist Nurses. The majority (58%) saw 2–5 patients with constipation each week, with 75% of patients reported to have symptoms for 6 months – 2 years. Reported service provision ranged from well-established MDT services, to no follow-up provision. 76% reported having a specialist nurse as part of their service.95% of respondents were confident or very confident in the management of constipation, compared to 63% reporting being satisfied or very satisfied with their current management.8% of respondents always used NICE guidance, 34% often and 33% sometimes/occasionally. The most common reasons for diversion from NICE guidance were clinical experience (58%), failure of treatment (43%), or advice from specialist colleagues (24%).Three key themes emerged from the initial thematic analysis: the need for a multidisciplinary approach; the need for improved education and awareness and the need for improved access to care.What does it mean? There is confidence in clinicians managing constipation (95%), yet only 67% feel satisfied with their current management. Many deviate from the NICE guidance and the services provided vary hugely. Analysis has identified important themes, and further work is ongoing to explore the management of constipation by clinicians in primary care. The aim is to inform future research studies in this condition, which is often neglected, yet produces significant workload for paediatric services as well as impacting on children and families.References Marcus KHA, Rakesh V, Paul F, Colin B. Childhood constipation. BMJ : British Medical Journal. 2012;345:e7309. doi:10.1136/bmj.e7309Cathie K, Sutcliffe AG, Bandi S, Coghlan D, Turner SW, Powell C. Priorities for child health research across the UK and Ireland. Arch Dis Child. 2022 May;107(5):474–478. doi: 10.1136/archdischild-2021-322636. Epub 2021 Oct 29. PMID: 34716174.",
  "authors": [
    {
      "affiliations": [
        "Portsmouth Hospitals University NHS Trust"
      ],
      "name": "Leah Crabtree"
    },
    {
      "affiliations": [
        "University Hospital Southampton NHS Foundation Trust"
      ],
      "name": "Katrina Cathie"
    }
  ],
  "title": "8356 Management of constipation: a UK-wide survey of clinician management and service delivery",
  "uid": "ffbdeb99-6f37-5d37-bc0d-34f0572539a3"
}