Hirschsprung's Disease in Children

Expert Q&A

Q. My grandson is now 10 weeks old and has difficulty passing stools. He was put on Magnesium Citrate, because the GI Ped wanted to do biopsies to rule out Hirschsprung's Disease. The biopsies came back showing that some nerve cells were missing. Since that procedure last week, he has now developed dark green stools. Could this be enterocolitis? He is being referred to a Pediatric Surgeon who can take a deeper sampling of tissue to confirm the disease. This baby is in a lot of pain, has difficulty passing gas and stool. Most of the time, he needs rectal stimulation to pass any stool. What are your thoughts? Jay, Placerville, CA

A. According to the National Institute of Diabetes and Digestive and Kidney Diseases, Hirschsprung's (HURSH-sprungz) disease, or HD, is a disease of the large intestine that can cause severe constipation. This is because a child with Hirschsprung's disease does not have these nerve cells in the last part of the large intestine. At this point, the stool stops moving. New stool then begins to stack up behind it.

Newborns with Hirschsprung's disease don't have their first bowel movement when they should. These babies may also throw up a green liquid called bile after eating and their abdomens may swell. Discomfort from gas or constipation might make them fussy. Sometimes, babies with Hirschsprung's disease develop infections in their intestines.

If a baby with Hirschsprung's disease develops fever and diarrhea, then that can be a sign that they have enterocolitis, which is an infection or inflammation of the large intestine.

Since you don't mention a fever or diarrhea, the dark green stools may not be a sign of enterocolitis. It may just be the effect of the Magnesium Citrate. Since enterocolitis is such a serious problem, you should call your doctor if you are concerned about this.

A biopsy is the most accurate test for HD.

The doctor removes and looks at a tiny piece of the intestine under a microscope. If the nerve cells are missing, Hirschsprung's disease is the problem.

Until you see the Pediatric Surgeon for the repeat biopsy, you might ask your Pediatric GI doctor for other ways to soften your grandson's stools so that he is not in as much pain. If he isn't breastfeeding, a soy or elemental formula, like Nutramigen, might help to loosen his stools enough so that they pass easier.

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