Controlled outcome of Hirschsprung’s disease beyond adolescence: a single center experience

• Published in: Pediatric surgery international Vol. 35; no. 2; pp. 181 - 185
• Main Authors: Gustafson, Elisabet, Larsson, Therese, Danielson, Johan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2019; Springer Nature B.V
• Subjects: Aganglionosis; Age; Bowel function; Child development; Fecal incontinence; Hirschsprung's disease; Laxatives; Long-term; Medicine; Medicine & Public Health; Original; Original Article; Patients; Pediatric Surgery; Pediatrics; Quality of life; Questionnaires; Surgery; Teenagers; Aganglionosis; Long-term; Bowel function; Hirschsprung’s disease; Quality of life
• ISSN: 0179-0358; 1437-9813; 1437-9813
• DOI: 10.1007/s00383-018-4391-5

Purpose
The aim of this study was to assess the function and quality of life of Hirschsprung’s Disease (HD) beyond adolescence and relate it to matched controls.
Methods
All 203 patients diagnosed with HD at our department from 1961 to 1995 were identified. 21 had died, 43 had unclear diagnosis and 16 could not be traced. The remaining 123 patients were sent bowel function and SF-36 quality of life questionnaires. 69 patients (mean age 37.8, range 22–58, 13 female) responded and were matched with 138 age and sex-matched controls.
Results
Function
: HD-patients had significantly higher number of bowel movements per week, higher incidence of soiling, urgency, permanent stomas, use of laxatives, enemas and loperamide. HD-patients also scored significantly lower in their satisfaction with their bowel function. There was, however, no significant difference in Miller Incontinence score.
QOL
: HD-patients reported a significantly higher incidence of negative impact by their bowel function on daily life, social interaction and ability to go on vacation. There were no significant differences in SF-36-scores.
Conclusions
Bowel function has a lifelong negative impact on the lives of patients with HD. This strongly indicates a need for structured follow-up beyond adolescence.