Hirschsprung's disease: outcome and how to follow-up

Abstract 

Definitive treatment of Hirschsprung's disease involves ‘pull-through’ surgery, either as a primary procedure or following formation of a preliminary colostomy. Regular follow-up is essential postoperatively as children often have problems with stool frequency, peri-anal excoriation, constipation or even recurrent episodes of enterocolitis. In the long term, 20–30% of children will suffer from significant constipation and/or soiling, and approximately 10% will have such severe problems that they may require re-formation of a stoma.

It is essential that parents be given a realistic expectation of outcome. They should be informed from the beginning that a significant number of children require aperients and enemas in the long term, while many experience continence problems extending into adolescence. Nonetheless, the majority of children with Hirschsprung's disease will attain a socially satisfactory bowel habit.

Keywords: Hirschsprung's disease, follow-up, enterocolitis, outcome, pull-through

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• f1 Correspondence to ELC. E-mail: eleri.cusick@ubht.swest.nhs.uk