Leonel Rodriguez, MD, MS, section chief of pediatric gastroenterology (GI) and hepatology at Yale School of Medicine (YSM), recently authored a new American Gastroenterological Association (AGA)-North American Society for Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN) Pediatric Functional Constipation (FC) Clinical Care Pathway, published today in Clinical Gastroenterology and Hepatology.
This clinical care pathway recommendation between the AGA and NASPGHAN is the first of its kind. The task force led by Dr. Rodriguez included experts in pediatric and adult gastroenterology, general pediatrics, behavioral health, and nutrition. Their goal was to determine how to best screen for, diagnose, and treat FC in children, as well as address the transition of patient care from childhood to adulthood.
First, they met to define FC and how to make a diagnosis. The team also discussed the role of testing and a range of treatment options, including drinking more water, eating more fiber, taking medication, exercising, making behavioral changes, or considering surgery. The doctors and researchers aimed to make a practical guide for office care that included real-world scenarios and was less restrictive than previous guidelines.
Yale faculty members Ada Fenick, MD, professor of general pediatrics, and Maggie Stoeckel, PhD, associate professor in the Child Study Center and director of the GI Psychology Service also helped create the clinical pathway, as well as a team of over a dozen experts from other institutions.
As for her participation on the study team, Dr. Fenick shared, “I was honored to be asked to serve as the general pediatrician on the task force - my job, I felt, was to try to give viewpoints that would enable the recommendations to be of practical, every-day use for a practicing primary care clinician. The skilled, mostly GI, specialist group was thoughtful about how it worked together to meld all viewpoints to form this clinical pathway.”
Dr. Stoeckel added, “Our multidisciplinary team is excited to disseminate our clinical pathway for functional constipation to community providers. The hope is that with this clinical pathway, we will streamline targeted treatment of functional constipation and improve long-term outcomes for our patients. As a GI Psychologist, I was honored to be a part of this effort to incorporate the role of behavioral interventions into this pathway. We do our best work when we are thinking holistically about our patients.”
Dr. Rodriguez hopes that this clinical pathway will be helpful to primary care pediatricians, APRNs, and PAs who see pediatric patients with FC. At Yale New Haven Children’s Hospital, it is one of the most frequently diagnosed and treated conditions by pediatric gastroenterologists.
See the guidance and recommendations in “AGA-NASPGHAN Pediatric Functional Constipation Clinical Care Pathway” in Clinical Gastroenterology and Hepatology, and please reach out with any questions to leonel.rodriguez@yale.edu.