AIM: Our aim was to examine the long-term bowel dysfunction that followed surgery for Hirschsprung's disease. METHODS: Of 414 patients diagnosed with Hirschsprung's disease between 1974 and 2002, 98 were interviewed using a structured questionnaire to provide an assessment of bowel function, medication, diet, physical and social limitations. Forty-two completed a prospective 4-week toileting diary and 16 underwent anorectal manometry. RESULTS: Four of the 98 patients had permanent stomas and 10 had Down's syndrome. Of the remaining 84 patients (mean age 12 +/- 8 years, range 1.9-41.9 years), 13% (11/84) had heavy soiling by day and 17% (14/84) by night. Fifty percent reported episodic urgency, but 36% also reported episodic constipation. Stool consistency was looser in patients with a history of long segment disease. Some aspects of bowel function improved with age. Enuresis was much more frequent than expected. Sixty-four percent reported adverse reactions to foods, particularly to fruit, vegetables, fats and diary products, and 15% limited their social activities because of fecal incontinence. There were no significant differences in manometric parameters between those patients who soiled and those who did not. CONCLUSIONS: Fecal incontinence is common after surgery for Hirschsprung's disease and has a significant impact on social activities. Some aspects of bowel function did improve with age. Adverse reactions to food were unexpectedly frequent and need to be further studied.
AIM: Our aim was to examine the long-term bowel dysfunction that followed surgery for Hirschsprung's disease. METHODS: Of 414 patients diagnosed with Hirschsprung's disease between 1974 and 2002, 98 were interviewed using a structured questionnaire to provide an assessment of bowel function, medication, diet, physical and social limitations. Forty-two completed a prospective 4-week toileting diary and 16 underwent anorectal manometry. RESULTS: Four of the 98 patients had permanent stomas and 10 had Down's syndrome. Of the remaining 84 patients (mean age 12 +/- 8 years, range 1.9-41.9 years), 13% (11/84) had heavy soiling by day and 17% (14/84) by night. Fifty percent reported episodic urgency, but 36% also reported episodic constipation. Stool consistency was looser in patients with a history of long segment disease. Some aspects of bowel function improved with age. Enuresis was much more frequent than expected. Sixty-four percent reported adverse reactions to foods, particularly to fruit, vegetables, fats and diary products, and 15% limited their social activities because of fecal incontinence. There were no significant differences in manometric parameters between those patients who soiled and those who did not. CONCLUSIONS: Fecal incontinence is common after surgery for Hirschsprung's disease and has a significant impact on social activities. Some aspects of bowel function did improve with age. Adverse reactions to food were unexpectedly frequent and need to be further studied.
Authors: R Hotta; L S Cheng; H K Graham; W Pan; N Nagy; J Belkind-Gerson; A M Goldstein Journal: Neurogastroenterol Motil Date: 2015-12-20 Impact factor: 3.598
Authors: Olugbenga Michael Aworanti; Dermot Thomas Mcdowell; Ian Michael Martin; Judy Hung; Feargal Quinn Journal: Pediatr Surg Int Date: 2012-09-22 Impact factor: 1.827
Authors: Akemi L Kawaguchi; Yigit S Guner; Stig Sømme; Alexandria C Quesenberry; L Grier Arthur; Juan E Sola; Cynthia D Downard; Rebecca M Rentea; Patricia A Valusek; Caitlin A Smith; Mark B Slidell; Robert L Ricca; Roshni Dasgupta; Elizabeth Renaud; Doug Miniati; Jarod McAteer; Alana L Beres; Julia Grabowski; Shawn D St Peter; Ankush Gosain Journal: J Pediatr Surg Date: 2021-03-28 Impact factor: 2.549