A Cross-sectional Survey on the Perception of Pediatricians about Constipation in Indian Pediatric Patients (CROSCIP)

Abstract

Background: Constipation accounts for more than 50% of the workload in pediatric outpatient clinics, with functional constipation being the most frequently diagnosed condition. Pediatricians have varied perceptions about constipation and its management. Objective: A national prospective questioner based cross-sectional survey was conducted to understand the perceptions and practices of Indian pediatricians on the current management of pediatric constipation. Methods: A 14-item questionnaire with open and closed-ended questions was developed with a focus on understanding the prevalence of constipation in the pediatric setting, common clinical presentations, management approaches, treatment choices, and patient compliance. Pediatricians PanIndia, among varied practice backgrounds, were invited to participate in the survey. Results: A total of 1150 pediatricians were invited, of which 1042 completed the survey. The majority of the responding pediatricians were based in the outpatient clinic setting. The most common age group of children presenting with functional constipation was 2-4 years. The most commonly reported symptoms were painful passage of hard and dry stools with a frequency of fewer than two stools per week. Polyethylene glycol (PEG) 4000 was the preferred choice for fecal disimpaction and maintenance by the majority of pediatricians. Most pediatricians prescribe laxatives for 1-3 months. The major challenge with PEG 3350 was the volume to be consumed and poor palatability. The survey results showed poor compliance and a high relapse rate in children with functional constipation. Conclusion: Functional constipation is prevalent in toddlers with growing incidence and is managed by pediatricians in outpatient clinics. We found that Indian pediatricians prefer PEG 4000 for fecal disimpaction and maintenance therapy.