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NICE: Keeping kids with constipation out of A&E

NICE: Keeping kids with constipation out of A&E

NICE: Guidance on keeping kids with constipation out of A&E

Guidance on helping children with idiopathic constipation to avoid A&E has been released by the National Institute of Health and Care Excellence. 

School nurses, GPs, pharmacists and other healthcare professionals have been urged to provide parents and carers with appropriate information about the condition. 

Constipation is very common in childhood, and can cause serious pained, with chronic symptoms if it is not diagnosed and treated early enough. 

Around 1% of children and young people get a constipation that has no known cause (idiopathic constipation). 

Children with constipation should receive: 

 - Full assessment, including detailed history-taking and a physical examination, to ensure all other serious causes of constipation are ruled out before a diagnosis of idiopathic constipation is made.

 - Treatment with laxatives that can be easily administered at home and do not need invasive hospital treatment – the first-line treatment should be oral macrogolsii unless otherwise indicated. Those who do not respond to treatment within three months should be referred to a specialist.

 - Timely review of treatment depending on the individual’s needs: within one week for those receiving laxative stimulants to clear a blockage, and within six weeks for those receiving ongoing treatment (either as their first treatment or after treatment to clear a blockage).

 - Clear, written information about how to take the medicine and what to expect when taking laxatives. They should also be informed about how bowels work, how to poo and how to recognise when they are at risk of constipation recurring.

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE said: “More than a third of children and young people will end up with chronic, long-term symptoms, with many having to be referred on to secondary care. This new standard calls for thorough and regular assessment to ensure that children and young people with idiopathic constipation have the best level of care.”

June Rogers MBE, PromoCon team director, disabled living and member of the committee which developed the standards said: “Constipation can cause a lot of pain and distress for children and young people and this can have an effect on the entire family.

"This standard highlights the importance of giving parents and carers adequate information to aid with self-management of their child’s idiopathic constipation and to encourage adherence to medication at home.”

The guidance is available to view on the NICE website

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