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Long-term continence after surgery for Hirschsprung's disease
Anthony G Catto-Smith1, Misel Trajanovska, Russell G Taylor
1Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Parkville, Victoria, Australia. tony.cattosmith@rch.org.au
Journal of Gastroenterology and Hepatology
|November 23, 2007
Summary
Long-term bowel dysfunction, including fecal incontinence, is common after Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Colorectal Surgery
Background:
- Hirschsprung's disease is a congenital condition affecting the large intestine.
- Surgery is the primary treatment for Hirschsprung's disease.
- Long-term outcomes and potential complications require ongoing investigation.
Purpose of the Study:
- To investigate the prevalence and nature of long-term bowel dysfunction following surgical correction of Hirschsprung's disease.
- To assess the impact of this dysfunction on patients' quality of life and social activities.
- To identify factors that may influence bowel function outcomes post-surgery.
Main Methods:
- A cohort of 98 patients who underwent surgery for Hirschsprung's disease between 1974 and 2002 were interviewed.
- A structured questionnaire assessed bowel function, medication use, diet, and physical/social limitations.
- A subset of patients completed a toileting diary and underwent anorectal manometry.
Main Results:
- Fecal incontinence (soiling) affected 13% by day and 17% by night in a cohort of 84 patients.
- Episodic urgency was reported by 50%, and constipation by 36%.
- Adverse food reactions were frequent (64%), impacting social activities for 15% due to incontinence.
Conclusions:
- Fecal incontinence is a significant and common long-term complication after Hirschsprung's disease surgery.
- Bowel function can improve with age, but social impact remains considerable.
- The high incidence of adverse food reactions warrants further research and dietary consideration.
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