Document Detail

Long-term continence after surgery for Hirschsprung's disease.
MedLine Citation:
PMID:  18031392     Owner:  NLM     Status:  MEDLINE    
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.
Anthony G Catto-Smith; Misel Trajanovska; Russell G Taylor
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  22     ISSN:  0815-9319     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-22     Completed Date:  2008-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  2273-82     Citation Subset:  IM    
Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Parkville, Victoria, Australia.
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MeSH Terms
Abdominal Pain
Child, Preschool
Delivery of Health Care
Fecal Incontinence / etiology*
Hirschsprung Disease / surgery*
Postoperative Complications / etiology*
Quality of Life
Time Factors

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