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School toilet facilities perception of children with hirschsprung disease: a parents perspective

A C Ter Schure1,2,3, S P van Streun4,5,6, C M C de Beaufort4,5,6

  • 1Department of Pediatric SurgeryAmsterdam Pediatric Abdominal Center, Emma Children's HospitalAmsterdam University Medical Centers, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands. a.c.terschure@amsterdamumc.nl.

Pediatric Surgery International
|December 8, 2025
PubMed

Insights

Many children with Hirschsprung Disease (HD) avoid school toilets for defecation. Improving school toilet facilities and policies can enhance their well-being.

Area of Science:

  • Pediatric Gastroenterology
  • Child Health
  • Medical Sociology

Background:

  • Access to adequate toilet facilities is crucial for children with Hirschsprung Disease (HD).
  • Parental perceptions of school toilet environments are vital for understanding children's experiences.
  • Hirschsprung Disease presents unique challenges for affected children in public settings.

Purpose of the Study:

  • To evaluate parental perceptions of school toilet facilities for children with Hirschsprung Disease.
  • To identify factors influencing children's use of school toilets.
  • To understand the impact of school environments on children with HD.

Main Methods:

  • A cross-sectional survey was conducted with parents of children aged 4-13 years with HD.
  • Questionnaires included quantitative and qualitative questions on toilet use frequency and experiences.
  • Data analysis involved both statistical and thematic approaches.

Main Results:

  • Over half of children with HD used school toilets for urination and defecation; a significant minority avoided them.
  • Positive experiences were linked to self-cleaning opportunities; negative experiences correlated with a lack of specific toilet rules.
  • Key themes influencing experiences included assistance, facilities, school rules, and the medical nature of HD.

Conclusions:

  • Toilet avoidance for defecation is prevalent among children with HD in school settings.
  • Enhancements in school toilet facilities, personalized support, and tailored policies are recommended.
  • Improving the school toilet environment can positively impact the well-being of children with HD.
Abstract

Keywords:
Defecation withholdingHirschsprung diseasePediatric continenceSchool aged childrenToilet avoidance

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