37^th Global Summit on Pediatrics May 15-16, 2023 Madrid, Spain

Introduction: Functional constipation in children who did not adequately respond to laxative treatment is a problem that significantly affects the quality of their life. Interferential current stimulation (IFS) has recently been mentioned as an adjuvant therapy in order to boost the effect of conventional treatment. The aim of our study is to examine the potential effect of IFS in children with functional constipation who partially responded to laxative treatment. Methods: A prospective study was conducted at the pediatric physiatry department at the Institute for Children's Diseases of the Clinical Hospital Center of Montenegro in 24 children who, despite long-term laxative treatment, had less than 3 bowel movements per week. IFS was applied daily for two weeks, without interruption of laxative therapy. Patients filled in a defecation diary (number of defecations/week, consistency, pain during defecation) before starting the treatment, after the treatment itself and 4 weeks after the end of the treatment. Results: After IFS treatment, 18/24 children improved their defecation frequency (median 4.2 defecations/week vs 2.6 defecations before treatment). 14/18 children after 4 weeks reduced the pattern of frequency of defecation (median 2.8 defecations/week). The effect of IFS was not significant on stool consistency and pain during defecation. Conclusion: IFS treatment in children with functional constipation had an effect on the frequency of defecation during the treatment itself, with a significantly reduced effect after a 4-week follow-up. Studies on a larger number of subjects are necessary, as well as an examination of the effect with repeated IFS treatments.

Jessica has completed her certification as a Pediatric Nurse Practitioner specialized in Acute Care at the age of 27 years from Vanderbilt University. She is an Instructor in the Pediatric Intensive Care Unit at Children’s Hospital of Colorado with a history of practicing as a Registered Nurse specialized in Hematology, Oncology and Bone Marrow Transplant at Duke Unversity. She currently has research underway on Code Improvement in the PICU.

I present a case of a previously healthy adolescent male who initially presented to his primary care physician with the chief complaint of a “large and white tongue,” who subsequently was diagnosed with end-stage kidney disease (ESKD) and associated uremic stomatitis. This patient required admission to a Pediatric Intensive Care Unit (PICU) for acute renal replacement therapy with intermittent hemodialysis, and his hospital course was complicated by generalized tonic-clonic seizures. ESKD is difficult to diagnose in the pediatric population because these patients are often asymptomatic in the early stages given the insidiousness of underlying disorders. Renal disease should be considered in the differential diagnosis of a child with a white tongue not being the result of oral candidiasis.