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216 Chapter 10 Our primary aim of this study was to investigate physicians’ familiarity with the 2014 ESPGHAN/NASPGHAN guideline. Our secondary aimwas to assess if physician’s approaches are consistent with this guideline. Moreover, we hypothesized that physicians would avoid items of the medical history and physical examination that could be perceived as uncomfortable or embarrassing, such as inquiring about sexual abuse and performing a perianal inspection or DRE. Therefore, our tertiary aim was to assess how frequently physicians inquire about sexual abuse and perform perianal inspection and DRE in the evaluation of FC. METHODS Study population We included physicians working in pediatrics and pediatric gastroenterology in either the Netherlands or the U.S. We invited all participants attending the following meetings to partake in this survey: 1. Pediatric gastroenterology review course organized by the European Postgraduate Gastrosurgical School (EPGS) held in Amsterdam, the Netherlands in September 2016 2. Annual Seminar of the California District of the American Academy of Pediatric held in Las Vegas, NV, U.S. in November 2016 3. Regional pediatric gastroenterology symposium held in Amsterdam, the Netherlands in December 2016 4. NASPGHAN Board Review Course held in Scottsdale, AZ, U.S. in February 2017 For this study, only surveys answered by physicians who reported that they treated children with FC were included. Furthermore, we invited general pediatricians from a secondary and a tertiary hospital in Amsterdam to partake in this survey study and we sent an email to all registered pediatric gastroenterologists in the Netherlands inviting them to participate. Questionnaire We developed a questionnaire containing 19 multiple-choice questions. The questions assessed factors related to the work setting, familiarity with the 2014 ESPGHAN/NASPGHAN guideline and the diagnostic and therapeutic approach towards children with FC. The questionnaire is provided as Supplemental Digital Content ( http://links.lww.com/MPG/ B148).