Pediatr Gastroenterol Hepatol Nutr.  2024 Mar;27(2):125-135. 10.5223/pghn.2024.27.2.125.

Rome IV Clinical Criteria and Management of Functional Constipation: Indonesian Health Care Professionals’ Perspective

• Darma A
• Sumitro KR
• Muhardi L
• Vandenplas Y
• Hegar B

• KMID: 2554075
• DOI: http://doi.org/10.5223/pghn.2024.27.2.125

Abstract

Purpose
The updated ROME IV criteria for functional constipation (FC) in children were published in 2016. However, information on the use of these criteria is scarce. This study aimed to report the frequency of the use of the ROME IV criteria by Indonesian pediatricians and general practitioners (GPs) in FC management in infants and toddlers.
Methods
An anonymous cross-sectional online survey was conducted between November 2021 and March 2022.
Results
A total of 248 respondents (183 pediatricians and 65 GPs) from 24 Indonesian provinces completed the survey. Most respondents reported an estimated prevalence of FC to be less than 5% both in infants and toddlers. On average, only 64.6% of respondents frequently used the ROME IV criteria. Pediatricians used the ROME IV criteria more often than GPs did (p<0.001). The most frequently used criteria were painful or hard bowel movements (75.0%) and ≤2 defecations/week (71.4%). Lactulose as a laxative was the preferred treatment choice, followed by changing the standard formula to a specific nutritional formula. Most of the respondents carried out parenteral reassurance and education. Normal growth, as a marker of good digestion and absorption function, and normal stool consistency and frequency were the most reported indicators of gut health.
Conclusion
The ROME IV criteria for functional constipation are not extensively used by pediatricians and GPs in Indonesia. Laxatives and specific nutritional formulas were the most used management approaches in infants and toddlers. Medical education, especially for general practitioners, should be updated.

Keyword

Constipation; Infants; Child, preschool; Health personnel; Indonesia