A Reading on Hirschsprung In Partial Fulfillment of the Requirements in NCM 207 RLE PEDIA ROTATION Submitted to: Prof. Marc Jade Adlawan, RN Clinical Instructor Submitted by: Arvin Joshua C. Lazarte St. N BSN 2L – GROUP 2 January 31, 2021 Title: Hirschsprung Disease in Children Bibliography: Stanford Children’s Health. (2014, April 28). default - Stanford Children’s Health. Stanfordchildrens.Org. Retrieved January 31, 2022, from https://www.stanfordchildrens.org/en/topic/default?id=hirschsprungs-disease-90-P01999 Summary: Hirschsprung disease is a rare birth defect. It affects the nerve cells in the large intestine. These nerve cells control the muscles that move food and waste, or stool, through the large intestine. The large intestine is the last part of the digestive tract. Babies with Hirschsprung disease are missing nerve cells in all or part of the large intestine. In most cases, only the end parts of the colon are affected. Without these nerve cells, the muscles can’t move food and waste through that part of the large intestine. Stool can’t move forward. It stays in the large intestine. The intestine can become partly or fully blocked. It begins to grow larger than normal. This can cause constipation, swelling, pain, and infection. During pregnancy, a baby’s nerve cells form along the intestines. They begin in the mouth and end in the anus. In babies with Hirschsprung disease, the nerve cells don’t grow past a certain part of the large intestine. Experts don’t know why this happens. Boys are more likely to have Hirschsprung disease than girls. Most babies with Hirschsprung disease have symptoms in the first few weeks of life. In some cases only a short part of the intestine may be affected. Then symptoms may not be seen for a few months or years. Each child’s symptoms may vary. Symptoms in newborns may include: Not having a bowel movement in the first 48 hours of life Slow swelling or bloating of the belly Vomiting green or brown fluid Children who don’t show early symptoms may also have: Constipation that gets worse over time Loss of appetite Slow or delayed growth Small, watery, bloody stools Loss of energy Symptoms of Hirschsprung disease may seem like other health problems. See your child's healthcare provider for a diagnosis. Your child’s healthcare provider will do an exam and take a health history. The provider will ask questions about constipation and bowel movements. Other tests may be done to find out if your child has Hirschsprung disease. These tests may include: Abdominal X-ray Barium enema Anorectal manometry. Biopsy of the rectum or large intestine Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Hirschsprung disease is treated with surgery called a pull-through procedure. A surgeon removes the part of the large intestine that lacks nerve cells. When possible, the healthy part that is left is connected to the anal opening. In some cases surgery may be done in 2 stages. A child who is very sick from Hirschsprung disease may first need ostomy surgery. This can help the child heal before the pull-through surgery. With ostomy surgery, the diseased part of the large intestine is removed. The end of the healthy intestine is moved to an opening made in the belly. This opening is called a stoma. Stool passes through the stoma and into a bag worn outside the body. The bag must be emptied several times a day. An ostomy may be short-term, or temporary. Or it may be permanent. It depends on how much of the intestine must be removed. If it is short-term, the surgeon will connect the healed intestine to the anus and sew the stoma closed. Reaction: As I was reading the article, the first thing that came to mind was a conversation I had with a friend way back in eighth grade about his neighbor. He told me that his friend eliminates wastes from his body through the side of his belly into a bag. What I remember from that conversation is thinking how hard life is for him if he can’t defecate properly. Back then I didn’t know or have any knowledge regarding what condition he had. It just amazes that since I became a student nurse, random unanswered questions have now been answered. Next time, when these things come up, I can now share what I’ve learned.
