Chronic constipation in children, Hirschsprung's disease

In 1887, for the first time in the history of medicine, the clinical picture and all the main signs of such a disease, for the first time at that time manifested itself, as gigantism of the colon, were described, albeit not in full. The doctor who made this discovery and made the description was the pediatrician from Denmark Harold Hirschprung, whose name was later called this disease. Long years of continuous, thorough scientific research have not been fruitless: scientists have found the cause of this pathology. It turned out that this disease develops due to the incorrect formation of certain sections of the walls of the large intestine. It should be noted that this disease is often manifested in children. In this article, "Chronic constipation in children: Hirschsprung's disease," we will look at some of the characteristics of this disease, as well as methods for its diagnosis and methods of treatment.

Hirschsprung's disease can have several symptoms, their manifestation largely depends on the age category. By the way, boys are more susceptible to this disease than female representatives (they suffer from this disease five times more often). Symptoms also differ depending on the location of the lesion of the intestine, the time of their manifestation and the various complications associated with Hirschsprung's disease. Below are the signs that reveal themselves in children of different ages.

Disease Hirschsprung in children up to one year is manifested as follows:

In children from one year to the next, the following features of Hirschsprung's disease are more common:

Thus, it can be noted that in both age categories, the main sign of Hirschsprung's disease is chronic constipation, which may well develop into chronic ones. This disease is more difficult to notice in newborns, since breastfeeding allows the stool to pass through the intestines much more freely, but with the beginning of the feeding, constipation becomes more pronounced, because the consistency of the stool becomes thicker. Due to the fact that the chair departs with delays, the organism becomes intoxicated, which leads to vomiting. It is worth noting that the more the disease progresses, the less the result is the cleansing enema.

Swelling of the abdominal cavity - another sign of Hirschsprung's disease, is caused by flatulence. This can be noticed, since the very form of the abdomen changes: the navel is displaced lower than it should be and becomes as if turned out, the stomach itself is asymmetric. The gut also shifts to the side.

However, Hirschsprung's disease is not only a childish disease, it can be suffered by adults. The causes of the disease in adults - flatulence, the inability to self-defecating since childhood, pain in the abdominal cavity due to regular delays in defecation.

Hirschsprung's disease includes several stages: a compensated stage, a subcompensated and decompensated stage. The first is characterized by constipation from childhood, which can be effectively reduced to zero by using cleansing enemas. However, these enemas become ineffective already at the second stage, and, consequently, the patient's condition worsens, as it starts to ache in the abdominal pain, shortness of breath. Also at the second stage, metabolism is disrupted and a noticeable weight loss occurs. The third, most severe stage is characterized by chronic pain and heaviness in the abdominal cavity. With great physical exertion and the transition to an unusual food for the patient can lead to such a complication as acute intestinal obstruction. Complete defecation can not be achieved in the usual ways: no cleansing enemas, no laxatives.

By the way, newborns can suffer from an acute form of Hirschsprung's disease, and this disease is characterized by a decreased intestinal obstruction.

The method of treatment of this disease is only one - it is a surgical intervention, which is best done at the age of 2-3 years. However, surgery is preceded by conservative treatment, which can be performed at home. A special diet is prescribed that is consistent with the patient's age, which includes such foods as apples, honey, beetroot, carrots, various porridges (oatmeal, buckwheat, etc.). It is also necessary to constantly use sour-milk products. The diet is prescribed for one purpose: regular defecation, and the above products help strengthen intestinal peristalsis. In addition to diet, the patient's child is prescribed a massage of the abdominal cavity and special therapeutic gymnastics. It is necessary to regularly use and various types of enemas, for example, such as Vaseline, cleansing, siphon, hypertonic.

The patient is under constant supervision of a doctor for another year and a half after the operation. In the course of clinical examination, he is again assigned a special diet, a course of cleansing enemas, a set of therapeutic physical exercises. By the way, cleansing enemas must be placed at the same time - this is necessary in order to develop a conditioned reflex to complete evacuation of the intestine. During this period of rehabilitation, the child's parents are in no doubt just bound to control his defecation.