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Faecal composition after surgery for Hirschsprung's disease
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Postoperative Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Colorectal Surgery
Background:
- Hirschsprung's disease treatment involves endorectal pull-through.
- Diarrhea and perianal excoriation are common complications post-surgery.
Purpose of the Study:
- To analyze fecal abnormalities in postoperative Hirschsprung patients.
- To determine the cause of perianal excoriation in these patients.
Main Methods:
- Faecal analysis of 3-day stool collections.
- Comparison between 17 postoperative Hirschsprung patients and 14 normal children.
Main Results:
- Loose stools showed reduced dry solids and excess fecal water with high sodium concentration.
- Formed stools had reduced dry solids but normal water content.
- Daily fecal water output was normal in patients.
Conclusions:
- Abnormal water absorption in the distal colon causes excess fecal water in loose stools.
- High sodium concentration in fecal water is linked to perianal excoriation.
Abstract:
Diarrhoea and perianal excoriation occur frequently after the endorectal pull-through operation for Hirschsprung's disease. A new method of faecal analysis was performed on 3-day stool collections in 17 postoperative Hirschsprung patients and in 14 normal children, in order to define the faecal abnormality and to establish the cause of perianal excoriation in these patients. Loose stools in postoperative patients were deficient in dry solid content and contained an excess of extractable faecal water. This also had a raised electrolyte concentration, particularly with respect to sodium. Total daily output of faecal water was normal. Formed stools from postoperative patients were also deficient in drysolids but had a normal extractable water content. Excess extractable faecal water, the main abnormality of loose stools in these patients, is the result of abnormal water absorption from the distal colon. Perianal excoriation in these patients is most closely associated with the concentration of sodium in faecal water.