Motility of the oesophagus and small bowel in adults treated for Hirschsprungâs disease during early childhood

Medhus, Asle W.; Björnland, Kristin; Emblem, Ragnhild; Husebye, Einar

doi:10.1111/j.1365-2982.2009.01397.x

Cited by 11 publications

(5 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data have shown that damage to the anal canal and a too low anastomosis cause fecal incontinence [19 , 20] . Since dysmotility in the upper gastrointestinal tract has been demonstrated in HD patients, it is not surprising that dysmotility also has been found in the remnant ganglionic colon [21][22][23] . A recent study found increased expression of protease-activated receptors in HD patients' colon that could be linked to inflammation, permeability and gut motility [24] .…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical outcomes after total transanal and laparoscopic assisted endorectal pull-through in patients with rectosigmoid Hirschsprung disease

Karlsen

Hoel

Fosby

et al. 2022

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Background: Total transanal (TERPT) and laparoscopic endorectal pull-through (LERPT) are the most common procedures to treat rectosigmoid Hirschsprung's disease (HD). Since few studies have compared the two methods, we aimed to assess clinical outcomes after TERPT and LERPT in this cross-sectional study. Methods and Patients: All patients with rectosigmoid HD operated with TERPT and LERPT between 2001 and 2018 were eligible. Peri-operative data were registered from patients' records, and bowel function was assessed according to the Krickenbeck classification. Results: 91/97 (94%) patients were included; 46 operated with TERPT and 45 with LERPT. Bowel function was assessed in 80 patients at median seven (4-17) years. There was no difference in functional outcome between the procedures. Unplanned procedures under general anesthesia were frequent; 28% after TERPT and 49% after LERPT ( p = 0.04). 11% of TERPT and 29% of LERPT patients got botulinum toxin injections ( p = 0.03). In the TERPT group, patients operated in the neonatal period had poorer outcome (78%) than those operated later (24%) ( p = 0.005). No difference in operative time, length of hospital stay, and rate of early and late complications was found between the procedures. Conclusion: There was no difference in long-term bowel function in patients with rectosigmoid HD operated with TERPT or LERPT. More LERPT patients had an unplanned procedure under general anesthesia, mostly due to obstructive symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of clinical outcomes after total transanal and laparoscopic assisted endorectal pull-through in patients with rectosigmoid Hirschsprung disease

Karlsen

Hoel

Fosby

et al. 2022

Journal of Pediatric Surgery

View full text Add to dashboard Cite

show abstract

“…A second group is children with continuing constipation and absent HAPCs, suggesting a neuropathy proximal to the aganglionic segment. It is worth noting that neuropathic motility abnormalities are seen in HD in esophagus, stomach, and small bowel of adults with HD treated in childhood (12,13). Therefore, it should come as no surprise that symptoms arise from motility problems in the remaining, presumably healthy colon.…”

Section: Discussionmentioning

confidence: 99%

Effect of Colon Transection on Spontaneous and Meal‐Induced High‐Amplitude–Propagating Contractions in Children

Jacobs¹,

Wolfson²,

Lorenzo³

et al. 2015

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

Background After Hirschsprung’s disease (HD) surgery, many children suffer fecal incontinence caused by increased number of high amplitude propagating contractions (HAPCs) propagating through the neorectum to the anal verge. The aim of this study was to determine whether children with HD have more HAPCs than children with colon transections for reasons other than HD. Methods We reviewed 500 colon manometries. Children (7.6±5.1 yrs; 275 male) with functional constipation (n=237; 7.4±5.0yrs; 126 male) and chronic abdominal pain (n=48; 9.8±5.8yrs; 25 male) served as controls compared to subjects with HD (n=56; 6.9±4.1yrs; 44 male) and colon transection for other reasons (n=24; 6.1±5.8yrs; 12 male). We excluded 139 subjects without HAPCs. We documented HAPCs during 1 h fasting and 1 h postprandial. Results are mean ± SD. Results During fasting, HD subjects had more HAPCs (2.2±3.4/h) vs. functional constipation (0.8±2.2/h, p=0.0004) and chronic pain (0.5±1.1/h, p=0.001), but not more than colon transection (1.9±3.2/h, p=1.0). HD showed more postprandial HAPCs (4.0±5.4/h) than functional constipation (1.5±2.5/h, p<0.0001) and chronic pain (0.9±1.6/h, p<0.0001), but not more than colon transection (2.4±3.0/h, p=0.6). There were more HAPCs fasting and post-prandial after colon transection (1.9 ± 3.2/h and 2.4±3.0/h) than functional constipation (0.8±2.2/h, p=0.3 and 1.5±2.5/h, p=1.0) and chronic pain (0.5±1.1/h, p=1.0 and 0.9±1.6, p=1.0). HD subjects were divided by chief complaint: fecal incontinence or constipation. HD subjects with incontinence (n=23) only had more HAPCs fasting (p=0.01) and post-prandial (p=0.01) than HD subjects with constipation (n=28) only. Conclusions Increased HAPCs followed colon transection, regardless of cause. HD subjects with incontinence had more HAPCs than subjects with colon transection for other reasons.

show abstract

“…A concomitant prevalence of esophageal and intestinal dysmotility has been described in several other entities, e.g. SSc [14,19], Hirschsprung's disease [20] and celiac disease [21]. Distinct esophageal and stomach physiologies, accompanied by different pathophysiology in esophageal dysmotility and gastroparesis, may explain the lack of association be-tween the two complications.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Dysmotility is More Common Than Gastroparesis in Diabetes Mellitus and is Associated With Retinopathy

Gustafsson¹,

Littorin²,

Berntorp³

et al. 2011

Rev Diabet Stud

View full text Add to dashboard Cite

show abstract

Motility of the oesophagus and small bowel in adults treated for Hirschsprungâs disease during early childhood

Cited by 11 publications

References 36 publications

Comparison of clinical outcomes after total transanal and laparoscopic assisted endorectal pull-through in patients with rectosigmoid Hirschsprung disease

Comparison of clinical outcomes after total transanal and laparoscopic assisted endorectal pull-through in patients with rectosigmoid Hirschsprung disease

Effect of Colon Transection on Spontaneous and Meal‐Induced High‐Amplitude–Propagating Contractions in Children

Esophageal Dysmotility is More Common Than Gastroparesis in Diabetes Mellitus and is Associated With Retinopathy

Contact Info

Product

Resources

About

Motility of the oesophagus and small bowel in adults treated for Hirschsprungâs disease during early childhood

Cited by 11 publications

References 36 publications

Comparison of clinical outcomes after total transanal and laparoscopic assisted endorectal pull-through in patients with rectosigmoid Hirschsprung disease

Comparison of clinical outcomes after total transanal and laparoscopic assisted endorectal pull-through in patients with rectosigmoid Hirschsprung disease

Effect of Colon Transection on Spontaneous and Meal‐Induced High‐Amplitude–Propagating Contractions in Children

Esophageal Dysmotility is More Common Than Gastroparesis in Diabetes Mellitus and is Associated With Retinopathy

Contact Info

Product

Resources

About

Motility of the oesophagus and small bowel in adults treated for Hirschsprungâs disease during early childhood