Journal of Pediatric Gastroenterology & Nutrition: June 2004 - Volume 39 - Issue !232-!233 "#!$%"&$!: Poster !

ession "'stracts

P0464 Table to Toilet (T.T.T ) Program for Management of Chronic Constipation and Encopresis
Karjoo M.!" Kesselring #.$
(ree "ccess %&thor 'nformation
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Pediatrics, SUNY Upstate Medical University, 2Pediatrics, Suny Upstate Medical University, Syracuse, United States !u'mitted 'y: *ar+oom,u state-edu 'ntrod&ction( &.ronic consti ation and enco resis is one of t.e most common ro'lems in Pediatrics- "'out 30/30 ercent of daily clinic 1isits of Pediatric Gastroenterology consist of t.is ro'lem- 2ost c.ildren .a1e a .istory of ta3ing multi le medications 4it.out im ro1ement- $.e $$$ rogram 5$a'le $o $oilet6 4as designed in our clinic 4it. e7cellent resultsMethods( $.is rogram includes t.at t.e atient go from t.e ta'le to t.e toilet after meals and sit ten to t4el1e minutes- (or c.ildren t.at .a1e not 'een toilet trained8 arents 4ere instructed to .old t.e c.ild in 3nee c.est osition 4.ile sitting on a c.air- $.ey 4ere treated 4it. a one-time enema if t.ey .ad im action follo4ed 'y a stool softener 5Polyet.ylene Glycol8 2ineral oil8 9actulose6 lus !enna e7tract- $.e stool softener and !enna 4ere gi1en toget.er- $.is com'ination .el s to maintain softness of stool 4.ile also .el ing 4it. e1acuation- $.e $$$ rogram 4as instructed as mentioned a'o1e and eac. c.ild 4as gi1en a diary to record daily toileting- $.ey 4ere told t.at t.ey mig.t re:uire .os itali;ation t.e ne7t 1isit if t.ey did not follo4 t.e instruction- $.is 4as mentioned so eac. 4ould understand t.e seriousness of t.e ro'lem and im ortance of treatment- "ll atients agreed to try t.eir 'est- $.e medication 4as continued for at least one mont. regardless of im ro1ement and continued e1en if t.e c.ild 4as .a1ing regular 'o4el mo1ements)es&lts( (rom January )999 to !e tem'er 20038 <=9 atients 4ere seen 4it. consti ation and enco resis at our clinic- >f t.ese8 492 .ad consti ation and )9? 4it. enco resis- $.ese included 430 males and 209 females 4it. t.e age range of 3 to )< years- Ninety ercent im ro1ed remar3a'ly after 2 mont.ly 1isits 4.en t.ey follo4ed t.e

medications and instructions- $.e ot.ers needed more 1isits for control of t.eir ro'lem%ecurrences .a ened if sto ed medication early or refused to continue toiletingConcl&sion( #e.a1ior modification as $$$ rogram 4ill 'e .el ful in t.e management of most atients 4it. consti ation and enco resis- 2edication alone 4ill result in tem orary im ro1ement 4.ile 'o4el-training results in com lete resolution 4it.out recurrence8 if continued toileting and 4it.out need of medications@ 2004 9i incott Ailliams & Ail3ins8 Inc-