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ERIC has welcomed the new National Institute for Health and Care Excellence (NICE) quality standard for childhood constipation which aims to improve care for children with constipation and help them avoid A&E.

Latest hospital statistics (2012/13) reveal that over three quarters (79%) of children who end up in hospital because of constipation are admitted via accident and emergency.

The Paediatric Continence Forum (PCF) played a key role in the development of the standard. The standard is aimed at helping healthcare professionals including GPs, pharmacists and school nurses to improve the care of children and young people with idiopathic constipation.

It sets out six concise statements designed to reduce emergency admissions and progression of symptoms, as well as prevent recurrence.

The standard also stresses the need to provide parents and carers with appropriate information about the condition. In summary, children and young people 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 macrogols (Movicol) 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 1 week for those receiving laxatives 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.

Jenny Perez, ERIC's Chief Executive said: "We’re delighted that a quality standard is now in place for childhood constipation. This will help to improve the quality of care provided for one of the most common health conditions in children and reduce related emergency hospital admissions.

Every year in England there are 13,000 hospital admissions among children with this condition – yet 80% of these admissions could be avoided through improved services in primary care, community and education settings.

Chronic constipation and soiling can have a devastating effect on a child and their family, and can result in social isolation and longterm physical, psychological and emotional problems.

This standard will play a key role in improving early diagnosis for childhood constipation, ensuring appropriate treatment is given by health professionals and supporting the development of effective, joined-up services.”

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: "There were over 13,000 consultant appointments for children and young people with constipation in the last year alone, and the number with the condition could be even higher because families may be too embarrassed to seek advice.

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.”

Follow this link for more information about childhood constipation.