{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:45:55Z","timestamp":1780494355236,"version":"3.54.1"},"reference-count":35,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVE:<\/jats:title>\n                  <jats:p>Constipation is a common pediatric condition with a prevalence of 3% to 5% in children aged 4 to 17 years. Currently, there are no evidence-based guidelines for the management of pediatric patients hospitalized with constipation. The primary objective was to evaluate practice patterns and patient outcomes for the hospital management of functional constipation in US children\u2019s hospitals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We conducted a multicenter, retrospective cohort study of children aged 0 to 18 years hospitalized for functional constipation from 2012 to 2014 by using the Pediatric Health Information System. Patients were included by using constipation and other related diagnoses as classified by International Classification of Diseases, Ninth Revision. Patients with complex chronic conditions were excluded. Outcome measures included percentage of hospitalizations due to functional constipation, therapies used, length of stay, and 90-day readmission rates. Statistical analysis included means with 95% confidence intervals for individual hospital outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>A total of 14\u2009243 hospitalizations were included, representing 12\u2009804 unique patients. The overall percentage of hospitalizations due to functional constipation was 0.65% (range: 0.19%\u20131.41%, P &amp;lt; .0001). The percentage of patients receiving the following treatment during their hospitalization included: electrolyte laxatives: 40% to 96%; sodium phosphate enema: 0% to 64%; mineral oil enema: 0% to 61%; glycerin suppository: 0% to 37%; bisacodyl 0% to 47%; senna: 0% to 23%; and docusate 0% to 11%. Mean length of stay was 1.97 days (range: 1.31\u20132.73 days, P &amp;lt; .0001). Mean 90-day readmission rate was 3.78% (range: 0.95%\u20137.53%, P &amp;lt; .0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>There is significant variation in practice patterns and clinical outcomes for pediatric patients hospitalized with functional constipation across US children\u2019s hospitals. Collaborative initiatives to adopt evidence-based best practices guidelines could help standardize the hospital management of pediatric functional constipation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2016-0101","type":"journal-article","created":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T08:35:19Z","timestamp":1496306119000},"page":"320-327","source":"Crossref","is-referenced-by-count":8,"title":["Hospital-Level Variation in Practice Patterns and Patient Outcomes for Pediatric Patients Hospitalized With Functional Constipation"],"prefix":"10.1542","volume":"7","author":[{"given":"Jamie","family":"Librizzi","sequence":"first","affiliation":[{"name":"Department of Pediatric Hospital Medicine, Phoenix Children\u2019s Hospital, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Flores","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hospital Medicine, Phoenix Children\u2019s Hospital, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Morse","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hospital Medicine, Phoenix Children\u2019s Hospital, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Kelleher","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hospital Medicine, Phoenix Children\u2019s Hospital, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi","family":"Carter","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hospital Medicine, Phoenix Children\u2019s Hospital, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Bode","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hospital Medicine, Nationwide Children's Hospital, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2017,6,1]]},"reference":[{"issue":"2","key":"2021120817243747100_B1","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/MPG.0000000000000266","article-title":"Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN","volume":"58","author":"Tabbers","year":"2014","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"2","key":"2021120817243747100_B2","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.jpeds.2008.07.060","article-title":"Health utilization and cost impact of childhood constipation in the United States","volume":"154","author":"Liem","year":"2009","journal-title":"J Pediatr"},{"issue":"4","key":"2021120817243747100_B3","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1038\/ajg.2015.64","article-title":"Emergency department burden of constipation in the United States from 2006 to 2011","volume":"110","author":"Sommers","year":"2015","journal-title":"Am J Gastroenterol"},{"issue":"6","key":"2021120817243747100_B4","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2009-0022","article-title":"Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG","volume":"124","author":"Bekkali","year":"2009","journal-title":"Pediatrics"},{"key":"2021120817243747100_B5","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/1471-2431-14-153","article-title":"A randomised, double-blind study of polyethylene glycol 4000 and lactulose in the treatment of constipation in children","volume":"14","author":"Treepongkaruna","year":"2014","journal-title":"BMC Pediatr"},{"issue":"4","key":"2021120817243747100_B6","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/00005176-200204000-00011","article-title":"Polyethylene glycol without electrolytes for children with constipation and encopresis","volume":"34","author":"Loening-Baucke","year":"2002","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"2","key":"2021120817243747100_B7","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1542\/peds.2006-0220","article-title":"A randomized, prospective, comparison study of polyethylene glycol 3350 without electrolytes and milk of magnesia for children with constipation and fecal incontinence","volume":"118","author":"Loening-Baucke","year":"2006","journal-title":"Pediatrics"},{"issue":"2","key":"2021120817243747100_B8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/00005176-199902000-00020","article-title":"Cisapride in management of chronic pediatric constipation","volume":"28","author":"Halabi","year":"1999","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"4","key":"2021120817243747100_B9","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1177\/000992280204100405","article-title":"Comparison of polyethylene glycol 3350 and lactulose for treatment of chronic constipation in children","volume":"41","author":"Gremse","year":"2002","journal-title":"Clin Pediatr (Phila)"},{"issue":"3","key":"2021120817243747100_B10","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1067\/mpd.2002.126603","article-title":"Dose response of PEG 3350 for the treatment of childhood fecal impaction","volume":"141","author":"Youssef","year":"2002","journal-title":"J Pediatr"},{"issue":"5","key":"2021120817243747100_B11","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1097\/01.mpg.0000181188.01887.78","article-title":"Double-blind randomized evaluation of clinical and biological tolerance of polyethylene glycol 4000 versus lactulose in constipated children","volume":"41","author":"Dupont","year":"2005","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2021120817243747100_B12","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1186\/1471-2431-12-178","article-title":"Efficacy and tolerability of peg-only laxative on faecal impaction and chronic constipation in children. 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