Hirschsprung's disease: symptoms in children, photos, causes, diagnosis, treatment

One of the common pathologies is Hirschsprung's disease. Symptoms in children are expressed in constant constipation. Sometimes the disease can occur in adults. But most often children suffer from it. This is a congenital disease that is inherited. It is diagnosed mainly in boys. It appears immediately after birth. When treating, only surgery is effective.

Pathology characteristic

This disease was described in 1887 by the Danish pediatrician Harold Hirschsprung, whose name was subsequently named after this ailment. The disease was originally called congenital gigantism of the colon. Pathology has another name. It is called congenital colon agangliosis . What is Hirschsprung's disease in children?

Symptoms (the photo shows the pathology) are dictated by individual characteristics, in which nerve ganglia do not form in the walls of the large intestine. Namely, they control the muscles that push the processed food through the intestine. The absence of nerve ganglia leads to the fact that muscle tissue does not function. Consequently, food does not move along the colon. This pathology is called Hirschsprung's disease. Symptoms in children are expressed in constipation, infections and inflammation.

The frequency of manifestation of Hirschsprung's disease is 1 in 5000. That is, only one in five thousand newborns suffers from this ailment. More often, the disease, as mentioned above, is diagnosed in boys.

Causes of pathology

Although this disease was described back in 1887, it took many years to identify the causes of the onset and development of this ailment.

Doctors cite several sources that provoke the development of such an unpleasant pathology as Hirschsprung’s disease in children.

The causes of the disease:

1. As a result of the studies, it was found that the formation of pathology occurs even with intrauterine development. Nerve congestions, which will perform the necessary functions in the digestion, are formed in the fetus from 5 to 12 weeks of pregnancy. In rare cases, the development of nerve cells in the digestive system of an infant does not occur completely. In the large intestine, they do not form. The causes of this pathology have not yet been elucidated. It is believed that mutations in DNA manifest themselves in this way.
2. Heredity is also noted in the occurrence of this disease. If there are cases of this disease in the family, then the likelihood that a sick child will be born is quite high. Especially if the male fetus, as boys suffer from this disease 4-5 times more often than girls.
3. In areas where there is increased radiation, more often children with Hirschsprung's disease are born.
4. A factor influencing the occurrence of this disease is Down syndrome.
5. Pathology can develop as a result of endocrine disorders in the mother.

Disease classification

There are several forms of such a pathology as Hirschsprung's disease (in children). Symptoms that appear in a child may indicate the type of ailment.

The following forms of Hirschsprung's disease are distinguished:

1. Compensated - constipation occurs at an early age. Cope with them with cleansing enemas for a long time.
2. Subcompensated - enemas do not have a facilitating effect. As a result of deterioration, weight loss occurs. The patient feels heaviness and pain in the abdomen. With this form of the disease, the appearance of shortness of breath, anemia is observed. Metabolism is undergoing noticeable changes.
3. Decompensated - the intestines cannot be cleaned with cleansing enemas and laxatives. After these measures, the feeling of heaviness in the lower abdomen and bloating do not stop. With a change in diet or strong physical exertion, a sharp bowel obstruction can develop . In pediatric patients, this form of the disease is established with subtotal and complete damage.
4. Acute - intestinal obstruction in newborns.

Symptoms of pathology

The disease can manifest itself in the first days of a child’s life. For example, if the intestine in a newborn does not empty during the first days of life, then it is necessary to examine the baby to identify the causes and establish a diagnosis. Perhaps this is Hirschsprung's disease.

Symptoms in children that you should pay attention to are as follows. The child refuses to eat. He has constipation. The intestines do not empty. The stomach swells. Husky breathing is observed. These are indicators that the baby has Hirschsprung's disease. Symptoms in children usually occur during the first month of life.

However, the disease can make itself felt much later. Therefore, you should carefully monitor the health of the crumbs. Contact your doctor right away if you observe signs that resemble Hirschsprung’s disease in a child.

Symptoms of the pathology that can be observed in infants up to a year:

• constipation
• lag in weight gain;
• bloating;
• vomiting
• diarrhea.

The possibility of the onset of the disease manifests itself at a later age.

The ailment is accompanied by the following symptoms:

• persistent constipation;
• feces come out in ribbons;
• the intestines are never completely empty.

What else to look for?

The main sign of the pathology of the large intestine is constant constipation. When breast milk is fed, this symptom may not occur. Painful symptoms occur only at the moment when complementary foods are introduced into the diet of the crumbs. Facilitates the use of enemas. But a favorable effect is observed only at first. Then the use of an enema ceases to give the desired result.

Changes in the size and shape of the abdomen, a lowered inverted navel are also indicators that are worth paying attention to. When overflowing, the colon moves, and the tummy assumes an asymmetric irregular shape.

Vomiting that occurs with this disease helps the body free itself from the stool that poisons it.

Hirschsprung's disease can also be detected in adulthood. Such patients, as a rule, suffer from constipation since childhood. They need medical help to empty their intestines. They complain of constant abdominal pain, often experience flatulence.

Pathology diagnostics

It is important to identify the disease in a timely manner.

Diagnosis of Hirschsprung’s disease in children includes the following methods:

1. Rectal examination. Detects an empty ampoule in the rectum. There is an increased activity of the sphincter.
2. Sigmoidoscopy. Detection of obstacles in the rigid sections of the rectum, absence or small amount of feces.
3. X-ray Detects tumors and enlargements of the loop of the colon.
4. Irrigography. The loops of the colon are increased to 10-15 cm in diameter. They extend to the entire abdominal cavity.
5. Passage of barium suspension. Contrast medium passes through the gastrointestinal tract, lingers in the colon. From there it does not come out for a long time. Sometimes delayed up to 5 days.
6. Ultrasound of the intestinal region.
7. Anorectal manometry. Intestinal pressure is measured.
8. Colonoscopy. The data shown by the x-ray is confirmed or refuted.
9. Swanson rectal wall biopsy. The presence of nerve ganglia in the large intestine is determined by extracting a fragment of the colon wall.
10. Histochemistry Establishes the activity of the enzyme tissue acetylcholinesterase.

Conservative treatment

You should not rely on such therapy. Treatment of Hirschsprung's disease in children is carried out in most cases exclusively by surgery. Conservative therapy mainly serves as a preparation for further surgery.

Preparatory treatment includes:

1. A specific diet, diet. Vegetables, fruits, sour-milk products, food that does not cause gas formation are recommended for use.
2. Massage, physiotherapy, gymnastics. They stimulate intestinal motility.
3. Cleansing enemas.
4. Intravenous administration of protein medicines and electrolyte solutions.
5. Vitamins

Surgery

It is it that allows the patient after rehabilitation to permanently get rid of Hirschsprung's disease.

2-3 years are considered the most suitable age of a child for surgery. Prepare the patient for surgery at home. For several weeks, you must follow a diet, empty the intestines with enemas. Special nutrition is definitely recommended by the attending physician, which takes into account the age and all the characteristics of the child’s body, as well as the stage of development of such an unpleasant ailment as Hirschsprung’s disease in children.

After surgery, the baby should be observed by a doctor for 2 years. At this time, the doctor makes an individual diet for the child. Parents must follow the baby's stool. It is recommended to put the baby cleansing enema daily, at the same time. This is necessary to develop a reflex of bowel movement.

Conclusion

Hirschsprung's disease is dangerous. It may not appear immediately. In this case, the child suffers from abdominal pain, nausea, vomiting for a long time. Parents need to monitor the regularity of the stool of the child and consult a doctor if there is any violation.