Hirschsprung’s disease is the most common reason for intestinal obstruction in newborns. Treated on time and correctly, it does not leave any sequelae.
The treatment of Hirschsprung’s disease has evolved over time. While it has become easier, today it also involves less risk and offers more satisfactory results.
Hirschsprung’s disease is the most common cause of neonatal lower intestinal obstruction. Out of every 5000 live newborns, one of them has this problem. Treatment of Hirschsprung’s disease almost always requires surgery.
Statistics indicate that when the disease is diagnosed in newborns, there is a higher prevalence in males. This is 4 for every 1.15 women. However, if the diagnosis is later, it is more frequent among women.
Hirschsprung’s disease is an obstruction of the large intestine. This is because there is poor muscle movement in the intestine. It is a congenital disease, that is, it is present at birth.
Because of this problem, children have a hard time passing stool. These do not circulate freely through the intestine, since there are not enough nerve cells in the lower part of the colon.
Usually the disease manifests itself at birth. However, there are also cases in which the difficulty in defecation only appears months or years later. It causes constipation, vomiting, and diarrhea. Sometimes it leads to more serious colon problems.
Treatment of Hirschsprung’s disease
Stabilizing the patient is usually the first step to treat Hirschsprung’s disease. This basically includes an anal dilation, rectal tube implantation, and warm saline lavage.
These measures allow you to decompress the colon and decrease abdominal distention. The steps that are followed depend on a number of factors. Among them the most important are:
- Magnitude of the problem.
- Age, health status and medical history of the child.
- Tolerance of the child to certain procedures, medications and therapies.
- Expectations regarding the evolution of the disease.
Hirschsprung’s disease is usually treated with surgery. In the case of newborns, surgery is generally postponed until they reach a greater weight and height. Meanwhile, they are treated with home rectal irrigations.
Most often, a rectal biopsy is ordered before defining treatment. This examination makes it possible to identify the extent and severity of the problem. This is critical in determining when and how the surgical procedure should be performed.
Surgery is the standard treatment for Hirschsprung’s disease. This can be done in one or two parts, depending on the severity of the case. When the little one is very ill or shows signs of malnutrition, the procedure is done in two parts.
The first part of the surgery is to remove the diseased part of the colon. Then an ostomy is done. This can be of two types:
- Ileostomy When the entire colon is removed. The small intestine is connected to a stoma.
- Colostomy Only part of the colon is removed. What is left of this is connected to a stoma.
When practicing the ostomy, the child’s stool passes up to the stoma and from there to a bag, which must be emptied several times a day. In this way, the colon heals enough to perform a second surgery, in which the hole is closed and the normal part of the colon is connected to the rectum.
In one-part surgery, a part of the colon that does not contain nerves is simply removed. The rectum is then religated with the remaining part of the colon. The usual thing is that it is done through laparoscopy, a minimally invasive procedure.
Visit: How to combat infant constipation
Postoperative and prognosis
After surgery, your child may feel uncomfortable for some time. Therefore, it is important to give him a diet rich in fiber to avoid complications. It is also essential that you drink plenty of water, as there is a risk of dehydration.
Sometimes the doctor prescribes some laxatives to relieve constipation. The use of these drugs should always be prescribed, as self-medication could cause serious complications. If symptoms persist or worsen, go to hospital immediately. This could be a symptom of enterocolitis or inflammation of the intestines.
In general, most children who undergo surgery heal and can lead completely normal lives with no further complications.