Constipation: Diagnosis, X-Rays, and more

What this episode covers

<br /> Where else is the poop going to be? Constipation is by and large a clinical diagnosis. This episode reviews how to make the diagnosis, red flags, and why X-Rays don&#8217;t necessarily help assess stool burden adequately in most children. <br /> <br /> <br /> <br /> This podcast episode is designed to disseminate the important work of Choosing Wisely, an initiative of the the American Board of Internal Medicine Foundation, the goal of which is the spark conversations between clinicians and patients about what tests, treatments, and procedures are needed – and which ones are not.<br /> <br /> <br /> <br /> The Choosing Wisely recommendation: Do not obtain abdominal radiographs for suspected constipation<br /> <br /> <br /> <br /> <a href="Medicinehttps://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWEmergencyMedicine.pdf" data-type="link" data-id="Medicinehttps://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWEmergencyMedicine.pdf">The Choosing Wisely Pediatric Emergency Medicine Recommendations</a><br /> <br /> <br /> <br /> <a href="https://www.aap.org/en/news-room/campaigns-and-toolkits/choosing-wisely/" data-type="link" data-id="https://www.aap.org/en/news-room/campaigns-and-toolkits/choosing-wisely/">The Choosing Wisely Campaign Toolkit</a><br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <a rel="noreferrer noopener" href="http://www.pwmblog.com" target="_blank">PEMBlog</a><br /> <br /> <br /> <br /> <a href="http://twitter.com/PEMTweets">@PEMTweets on&#8230; sigh &#8220;X&#8221; (Twitter)</a><br /> <br /> <br /> <br /> <a href="https://www.instagram.com/bradsobolewski/" target="_blank" rel="noreferrer noopener">My Instagram</a><br /> <br /> <br /> <br /> <a rel="noreferrer noopener" href="https://med-mastodon.com/@bradsobo" target="_blank">My Mastodon account @bradsobo</a><br /> <br /> <br /> <br /> References<br /> <br /> <br /> <br /> Anwar Ul Haq MM, Lyons H, Halim M. Pediatric Abdominal X-rays in the Acute Care Setting &#8211; Are We Overdiagnosing Constipation?. Cureus. 2020;12(3):e7283. Published 2020 Mar 15. doi:10.7759/cureus.7283<br /> <br /> <br /> <br /> Beinvogl B, Sabharwal S, McSweeney M, Nurko S. Are We Using Abdominal Radiographs Appropriately in the Management of Pediatric Constipation?. J Pediatr. 2017;191:179-183. doi:10.1016/j.jpeds.2017.08.075<br /> <br /> <br /> <br /> Berger MY, Tabbers MM, Kurver MJ, Boluyt N, Benninga MA. Value of abdominal radiography, colonic transit time, and rectal ultrasound scanning in the diagnosis of idiopathic constipation in children: a systematic review. J Pediatr. 2012;161(1):44–50.e502. DOI: <a href="https://doi.org/10.1016/j.jpeds.2011.12.045">https://doi.org/10.1016/j.jpeds.2011.12.045</a><br /> <br /> <br /> <br /> Freedman SB, Rodean J, Hall M, et al. Delayed diagnoses in children with constipation: multicenter retrospective cohort study. J Pediatr. 2017;186:87-94.e16. DOI: <a href="https://doi.org/10.1016/j.jpeds.2017.03.061">https://doi.org/10.1016/j.jpeds.2017.03.061</a><br /> <br /> <br /> <br /> Freedman SB, Thull-Freedman J, Manson D, et al. Pediatric abdominal radiograph use, constipation, and significant misdiagnoses. J Pediatr. 2014;164(1):83-88.e2<br /> <br /> <br /> <br /> Hoskins B, Marek S. Things We Do for No Reason&#x2122;: Obtaining an Abdominal X-ray to Asses