Management of Constipation in Children and Adolescents


The aim of the study was to develop a practical as well as readily applied algorithm for the primary healthcare providers to help them in the identification, evaluation, and management of constipation among children with autism spectrum disorders. The algorithm was developed through literature review and expert opinion of the Gastroenterology Committee of Autism Speaks Autism Treatment Network. The researchers also used a systematic review of the literature to get information concerning constipation of children with ASD (Furuta et al., 2012). Literature review limited the evidence of the treatment strategies of people with ASD and constipation.

  The ATN Gastroenterology committee consisted of the pediatric GI specialists who represented 14 sites and two others from developmental pediatrician representatives were involved in the review of the literature concerning constipation of children with ASD (Furuta et al., 2012). The committee utilized evidence using NASPGHAN evidence-based guideline as well as the algorithm template to collect information. The algorithm templates were modified to meet the clinician needs while serving the autism children (Furuta et al., 2012). They developed a complementary checklist to act as the practical tool. An ASD-specific algorithm was crucial to collect specific details. The specific checklist was utilized practically during the clinical visits of children with autism.

 The study findings included the presence of constipation as indicated by typical symptoms. The study identified that screening, identification, and treatment of the underlying causes of constipation is important. The diagnostic-therapeutic intervention is crucial once the constipation incidences are documented. The effectiveness and the tolerance of the therapy are identified by follow-up of the patients (Marshall, Ware, Ziviani, Hill & Dodrill, 2014).

 The study contributes to the clinical problem as it identifies constipation as a significant problem among children with ASD. The study aimed at developing a practical algorithm that is effective in the evaluation and management of constipation in ASD children by the primary healthcare practitioners. Children with autism spectrum disorders have often developed gastrointestinal symptoms such as constipation when compared to others (McElhanon, McCracken, Karpen & Sharp, 2014). The study contributes to the clinical problem as it emphasizes on a holistic approach to the care of children with ASD to incorporate aspects of managing constipations once the cases have been documented using therapeutic interventions. Through the review of the literature and clinical experience, the study finds constipation as a significant problem among the children suffering from ASD. Therefore, it contributes to the clinical problem by suggesting that management of constipation should be incorporated into the routine care of children with ASD. A systematic approach can be used to identify and manage constipation and the associated underlying etiology. However, the topic lacks enough evidence thus need for more research.

 I believe in the findings of the study because of its credibility regarding the methods used. The algorithm was developed by use of expert opinion and NASPGHAN guidelines thus making them reliable. Besides, it was complemented by the field testing to improve the reliability and validity. The clinical-based practical tool and the checklist were incorporated in the clinical visits and routine care of the patients to collect information on the constipation of children with ASD. The researchers field-tested the algorithm at 4 ATN sites to identify its suitability in collecting the desired information (Furuta et al., 2012). Besides, the feasibility of implementing the algorithm during the routine care of the children with constipation and ASD was determined. The sample used by the algorithm is adequate to make logical inferences as a total of 48 children were reached (Furuta et al., 2012).