Dyssynergic defecation may play an important role in postoperative Hirschsprung's disease patients with severe persistent constipation Analysis of a case series

Rob J. Meinds*, Maura C. Eggink, Erik Heineman, Paul M. A. Broens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

23 Citations (Scopus)

Abstract

Background: After surgery for Hirschsprung's disease (HD) the majority of patients have satisfactory clinical outcomes. Nevertheless, a substantial number of patients remain who suffer from severe persistent constipation. Current consensus attributes these complaints to the hallmarks of HD. In non-HD patients a cause for severe constipation is dyssynergic defecation.

Methods: Retrospectively, we reviewed the medical records of ten postoperative HD patients with severe persistent constipation who had undergone extensive anorectal function tests to diagnose the reason for the constipation. We analyzed the results of these tests.

Results: During the last three years, ten postoperative HD patients with severe persistent constipation were given extensive anorectal function tests. All ten patients were diagnosed with dyssynergic defecation. The ages at the time of diagnosis ranged from 7 to 19 years with a median age of 12 years. Signs of an enlarged rectum were seen in all ten patients, with a maximum measured value of 845 mL.

Conclusions: Patients with HD may also suffer from dyssynergic defecation. It is important to consider this possibility when dealing with severe persistent constipation in postoperative HD patients. Viable options for treating dyssynergic defecation are available that could prevent irreversible long-term complications. (C) 2014 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)1488-1492
Number of pages5
JournalJournal of Pediatric Surgery
Volume49
Issue number10
DOIs
Publication statusPublished - Oct-2014

Keywords

  • Hirschsprung's disease
  • Congenital megacolon
  • Dyssynergic defecation
  • Pelvic floor dyssynergia
  • Anismus
  • RECTAL FILLING SENSATION
  • PELVIC FLOOR DYSSYNERGIA
  • BIOFEEDBACK THERAPY
  • NATIONWIDE SURVEY
  • CONTROLLED-TRIAL
  • BOWEL FUNCTION
  • SURGERY
  • LIFE
  • EVACUATION
  • DISORDERS

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