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224 Chapter 10 gastroenterologists registered in the Netherlands (n=47) and returned by 29 (response rate 62%). Unfortunately, it is not possible to reliably calculate the response rate for the entire study. The questionnaire was distributed at conferences with heterogeneous participant compositions which cannot all be retrieved accurately. When interpreting the results of the comparisons between the Netherlands and the U.S., it should also be taken into account that the majority of U.S. physicians worked in primary care or private practice, which is highly uncommon in the Netherlands. Furthermore, a larger proportion of U.S. responders were pediatric gastroenterologists rather than general pediatricians. In conclusion, in our sample of physicians working in pediatrics and pediatric gastroenterology, almost a third of responders were not familiar with the ESPGHAN/ NASPGHAN guideline on FC. Nevertheless, therapeutic decisions correlated fairly well with recommendations from the guideline, especially for the treatment of children ≥1 year of age. Future research should assess guideline adherence in other countries and aim to develop strategies to improve guideline awareness and adherence. Digital learning tools carry low costs and can be distributed easily. Therefore, it appears valuable to further explore these options and to optimize the distribution and use of such tools. Optimally, the effect of such tools should also be studied in research settings. Furthermore, specific barriers that impair guideline awareness and adherence, especially in general pediatricians, need to be further investigated in order to tailor interventions appropriately. ACKNOWLEDGEMENTS The authors sincerely thank all responders who participated in this survey.