Abstract
Objective:
A group behavioral treatment protocol for pediatric encopresis was last described before significant medical advances have changed medical guidelines for constipation treatment, although no updated behavioral treatment protocols have been published. The current study aims to describe an updated interdisciplinary group treatment protocol for pediatric functional constipation and encopresis and evaluate this for feasibility and acceptability.
Method:
The development and protocol of the Functional Constipation Shared Medical Appointment (FC-SMA) is described in detail. Patients recruited for the initial 24 months of the integrated group treatment program were described and evaluated for protocol feasibility, acceptability, and initial treatment outcomes, utilizing attendance records, a standardized patient satisfaction questionnaire (PSQ), and treatment outcomes recorded in medical records, respectively.
Results:
Forty-9 patients enrolled in the FC-SMA, with 43 (87.8%) completing the initial 4-sesion protocol and 34 (69.4%) returning for at least 1 follow-up session. Parent satisfaction was high (PSQ M(SD) ranged from 4.41 (.56) to 4.56 (.50)). Initial treatment outcomes demonstrated improvement or resolution of constipation and encopresis in 83.7% and 67.4% of participants, respectively.
Conclusions:
An interdisciplinary group treatment model for pediatric functional constipation is feasible, acceptable to patients and parents, and demonstrates promising initial outcomes. Updated medical treatment recommendations require modernized complementary behavioral treatment protocols that further address the complex medical-behavioral interactions and ongoing adherence challenges associated with this population.
Implications for Impact Statement
This study describes a novel interdisciplinary group treatment protocol for pediatric functional constipation and encopresis. The treatment demonstrated high rates of completion and parental satisfaction and promising clinical outcomes, providing a new treatment option for these children that have historically struggled with poor treatment outcomes and significant emotional and functional impact.
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