Hirschsprung Disease
What I need to know about Hirschsprung Disease
- What is Hirschsprung disease (HD)?
- What are the large intestine, colon, rectum, and anus?
- Why does HD cause constipation?
- What causes HD?
- What are the symptoms of HD?
- How is HD diagnosed?
- How is HD treated?
- What will my child’s life be like after surgery?
- If I have more children, will they also have HD?
- Points to Remember
- Hope through Research
- For More Information
What is Hirschsprung disease (HD)?
Hirschsprung disease (HD) is a disease of the large intestine that causes severe constipation or intestinal obstruction. Constipation means stool moves through the intestines slower than usual. Bowel movements occur less often than normal and stools are difficult to pass. Some children with HD can’t pass stool at all, which can result in the complete blockage of the intestines, a condition called intestinal obstruction. People with HD are born with it and are usually diagnosed when they are infants. Less severe cases are sometimes diagnosed when a child is older. An HD diagnosis in an adult is rare.
What are the large intestine, colon, rectum, and anus?
The large intestine, which includes the colon and rectum, is the last part of the digestive tract. The large intestine’s main job is to absorb water and hold stool. The rectum connects the colon to the anus. Stool passes out of the body through the anus. At birth, the large intestine is about 2 feet long. An adult’s large intestine is about 5 feet long.
Why does HD cause constipation?
People with HD have constipation because they lack nerve cells in a part or all of the large intestine. The nerve cells signal muscles in the large intestine to push stool toward the anus. Without a signal to push stool along, stool will remain in the large intestine.
How severe HD is depends on how much of the large intestine is affected. Short-segment HD means only the last part of the large intestine lacks nerve cells. Long-segment HD means most or all of the large intestine, and sometimes the last part of the small intestine, lacks nerve cells.
In a person with HD, stool moves through the large intestine until it reaches the part lacking nerve cells. At that point, the stool moves slowly or stops, causing an intestinal obstruction.
What causes HD?
Before birth, a child’s nerve cells normally grow along the intestines in the direction of the anus. With HD, the nerve cells stop growing too soon. Why the nerve cells stop growing is unclear. Some HD is inherited, meaning it is passed from parent to child through genes. HD is not caused by anything a mother did while pregnant.
What are the symptoms of HD?
The main symptoms of HD are constipation or intestinal obstruction, usually appearing shortly after birth. Constipation in infants and children is common and usually comes and goes, but if your child has had ongoing constipation since birth, HD may be the problem.
Symptoms in Newborns
Newborns with HD almost always fail to have their first bowel movement within 48 hours after birth. Other symptoms include:
- green or brown vomit
- explosive stools after a doctor inserts a finger into the rectum
- swelling of the belly, also known as the abdomen
- lots of gas
- bloody diarrhea
Symptoms in Symptoms in Toddlers and Older Children
Symptoms of HD in toddlers and older children include:
- not being able to pass stools without laxatives or enemas. A laxative is medicine that loosens stool and increases bowel movements. An enema is performed by flushing water, or sometimes a mild soap solution, into the anus using a special wash bottle.
- swelling of the abdomen.
- lots of gas.
- bloody diarrhea.
- slow growth or development.
- lack of energy because of a shortage of red blood cells, called anemia.