Recognize Hirschsprung's Disease or Congenital Megacolon in Children

Hirchsprung's disease usually affects infants and young children. Normally, the intestines continually contract and expand to expel waste, a process controlled by the nervous system.

The following is what is meant by Hirschsprung's disease or Congenital Megacolon in children, namely:
- Congenital abnormalities in the distal/end of the large intestine
- Nerve cells (ganglion) in part of the large intestine are not formed
- Bowel movements are disrupted and have no fecal propulsion power
- Children cannot defecate or are constipated

 

In Hirschsprung's disease, the nerves that control bowel movements are missing at the end of the intestine. Therefore, stool can build up and cause a blockage. This condition can cause severe constipation and sometimes lead to a serious infection called enteritis if not detected and treated early. However, this condition often occurs after birth and can be treated with surgery as soon as possible.

 

The cause is unknown and is caused by genetic mutations. Then the risk factors that can occur are:

- If 1 child is diagnosed with Hirschsprung the risk increases for his siblings

- The risk occurs in boys is higher

- Children with Down Syndrome have an increased risk

If found in older children, the symptoms are:
- Enlarged stomach
- Chronic constipation / constipation requires laxatives
- Weight does not match age, there are growth and development disorders

 

The symptoms of Hirschsprung's disease are as follows :

If symptoms are found in infants, the symptoms are:
- Meconium (first bowel movement) comes out more than 48 hours after birth
- Enlarged stomach
- Vomiting
- Constipation

 

If found in older children, the symptoms are:
- Enlarged stomach
- Chronic constipation / constipation requires laxatives
- Weight does not match age, there are growth and development disorders

 

In this case, it can be life-threatening if Enterocolitis occurs, which is an infection of the small intestine and large intestine due to Hirschsprung, which can cause sepsis and death. If the child is examined by a pediatrician/surgeon, the child will undergo a radiology examination, namely performing an abdominal X-ray using barium enema/colon loop contrast and a definite diagnosis is made by biopsy.

 

For the management of Hirschsprung's disease, namely:
Initial management:
- Improvement of the child's condition if there are growth and development disorders/nutritional disorders
- Rectal washout/spooling/irrigation of the stomach is not bloated.
- Surgery to remove the intestines without ganglion (nerves) healthy intestines are lowered into the anus

 

So, in conclusion, only a small portion of constipation requires surgery, one of the signs of Hirschsprung's disease is chronic constipation. The sooner it is discovered and operated on, the better the results will be. To get an accurate diagnosis and appropriate treatment. Hermina's friends can consult a Pediatric Surgeon Specialist at RSU Hermina Solo.

 

Reference Source:
https://www.alodokter.com/penyakit-hirschsprung
https://yankes.kemkes.go.id/view_artikel/1762/kenali-tanda-dan-gejala-hisprung-pada-anak