Hirschsprung disease: symptoms in children, photos, causes, diagnosis, treatment
One of the most common pathologies is Hirschsprung's disease. Symptoms in children are expressed in permanent 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. Appears immediately after birth. In the treatment, only surgical intervention is effective.
Description of the pathology of
This disease was described in 1887 by the Danish pediatrician Harold Hirschprung, whose name was subsequently called this ailment. Initially, the disease was called congenital gigantism of the large intestine. Possesses pathology with one more name. It is called congenital aganglion of the large intestine. What is Hirschsprung's disease in children?
Symptoms( photo shows pathology) are dictated by individual characteristics, in which the nerve ganglia are not formed in the walls of the large intestine. Namely, they control the muscles that push the processed food down the gut. The absence of nerve ganglions leads to the fact that muscle tissue does not function. Consequently, the food does not move through the colon. This pathology is called Hirschsprung's disease. Symptoms in children are expressed in constipation, infections and inflammation.
The incidence of Hirschsprung's disease is 1 to 5000. That is, only one in five thousand newborns suffers from this ailment. More often the disease, as indicated above, is diagnosed in boys.
Causes of pathology
Although this disease was described as early as 1887, it took many years to identify the causes of the onset and development of this disease.
Physicians provide several sources that provoke the development of such an unpleasant pathology as Hirschsprung's disease in children.
Causes of the disease:
- As a result of the conducted studies it was found that the formation of pathology occurs even with intrauterine development. Nerve congestion, which will perform the necessary functions in 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 the infant does not take place completely. In the large intestine, they are not formed. The causes of this pathology have not yet been elucidated. It is believed that mutations in DNA thus manifest themselves.
- Also note a heredity in the onset of this disease. If there are cases of this disease in the family, the probability that a sick child will be born is quite high. Especially if the fetus is male, since boys suffer from this disease 4-5 times more often than girls.
- In areas where there is increased radiation, children with Hirschsprung disease are more likely to be born.
- Factor affecting the occurrence of this disease is Down's syndrome.
- Pathology can develop as a result of endocrine disorders in the mother.
Classification of the disease
There are several forms of such a pathology as Hirschsprung's disease( in children).Symptoms manifested in a child can indicate the type of ailment.
The following forms of Hirschsprung's disease stand out:
- Compensated - constipation occurs at an early age. Cope with them with the help of cleansing enemas for a long time.
- Subcompensated - enemas do not have a facilitating effect. As a result of deterioration, weight loss occurs. The patient feels the heaviness and pain in the abdomen. With this form of the disease, dyspnoea and anemia are observed. Metabolism undergoes noticeable changes.
- Decompensated - the intestine can not 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, sharp bowel obstruction can develop. In pediatric patients, this form of the disease is established with subtotal and total lesion. Acute intestinal obstruction in newborns.
Symptoms of pathology
The disease can appear already in the first days of a child's life. For example, if the intestine of the newborn is not emptied during the first day 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, which should be noted, look like this. The child refuses to eat. He has constipation. The bowel is not emptied. Swollen abdomen. There is a raucous breath. This is an indication that the baby has Hirschsprung's disease. Symptoms in children are manifested, as a rule, during the first month of life.
However, the ailment can make itself felt and much later. Therefore, you should carefully monitor the health of the crumbs. Immediately address to physicians if you observe the signs reminding illness Hirschsprung at the child.
Symptoms of a pathology that can be observed in infants up to one year:
- lag in gaining weight;
The possibility of the disease appears at a later age.
Followed by the following symptoms:
- feces come out with ribbons;The
- intestine is never fully released.
What else to pay attention to?
The main sign of the pathology of the colon is permanent constipation. When breastfeeding, this symptom may not appear. Painful signs occur only at the moment when the snack diet is introduced. Facilitates the use of enema. But a favorable effect is observed only at first. Then the use of the enema ceases to produce the desired result.
Changes in the size and shape of the abdomen, located a lowly turned navel - these are also indicators that you should pay attention to. At overflow the large intestine is displaced, and the tummy takes an asymmetrical irregular shape.
Vomiting that occurs with this disease, helps the body to free itself from the stools that poison it.
Hirschsprung disease can also be detected in adulthood. Such patients, as a rule, suffer from constipation from childhood. They need medication to empty their intestines. They complain of constant pain in the abdomen, often face flatulence.
Diagnosis of pathology
It is important to identify the disease in a timely manner.
Diagnosis of Hirschsprung's disease in children includes such methods:
- Rectal examination. Reveals an empty ampule in the rectum. There is increased activity of the sphincter.
- Recto-manoscopy. Detection of obstacles in the rigid parts of the rectum, absence or small amount of fecal matter.
- X-ray. Detects tumors and increases loops in the large intestine.
- Irrigography. The loops of the colon are enlarged to 10-15 cm in diameter. They extend to the entire abdominal cavity.
- Passage of barium suspension. Contrast substance passes through the gastrointestinal tract, is retained in the large intestine. From there it does not leave for a long time. Sometimes it takes up to 5 days.
- ultrasound of the intestinal region.
- Anorectal manometry. The pressure in the intestine is measured.
- Colonoscopy. Confirmed or refuted data that showed the X-ray. Biopsy of the rectum wall by Swanson. The presence of nerve ganglia in the large intestine is determined by the extraction of a fragment of the wall of the large intestine.
- Histochemistry. It establishes the activity of the enzyme tissue acetylcholinesterase.
Do not rely on this therapy. Treatment of Hirschsprung's disease in children is carried out in most cases exclusively by surgical means. Conservative therapy mainly serves as a preparation for further operative intervention.
Preparatory treatment includes:
- Defined diet, compliance with the diet. It is recommended to eat vegetables, fruits, sour-milk products, food, which does not cause gas generation.
- Massage, physiotherapy, gymnastics. They stimulate intestinal peristalsis.
- Cleansing enemas.
- Intravenous administration of protein medicines and electrolyte solutions.
It is this that allows the patient to get rid of Hirschsprung's disease after rehabilitation.
The most suitable age for a child is 2-3 years. Prepare the patient for surgery at home. For several weeks, you must follow a diet, empty the bowels with enemas. Special nutrition is recommended by the attending physician, which takes into account the age and all the characteristics of the child's organism, as well as the stage of development of such an unpleasant illness as Hirschsprung's disease in children.
After the operation the baby should be observed by the doctor for 2 years. At this time, the doctor makes for the child an individual diet. Parents must watch the baby's chair. It is recommended to put the cleansing enema in a crumb every day, at the same time. This is necessary to develop a bowel movement reflux.
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 child's chair and at the slightest infringement they should consult a doctor.