Treatments for Hirschsprung's disease

All children with Hirschsprung's disease will need surgery.

As they wait for surgery, theymay need to:

• stop having milk feeds and instead be given fluids directly into a vein
• havea tube passed through their nose and into their stomach to drain away any fluid and air collecting in it
• have regular bowel washouts, where a thin tube isinserted into their bottom and warm salt water is used to soften and flush out the trapped stools
• take antibiotics if they have enterocolitis

Your child may need to stay in hospital during this time, or you may be able to look after them at home. Your doctor will advise you about this.

Surgery

Most children will have the "pull-through" operation, where the affected section of bowel is removed and the remaining healthy sections of bowel are joined together. This will usually be done when they're around three months old.

If your child isn't well enough to have this procedure for example, because they have enterocolitis or a severe blockagethey may have it in two stages.

A few days after birth, the surgeon will divert the bowel through a temporary opening (stoma) made in the tummy. This procedure is called a colostomy formation.

Stools will pass directly out of the opening into a pouch worn on your child's body until they're well enough to have another procedure to remove the affected section of bowel, close the opening, and join the healthy sections of bowel together. This is usually done at around three months of age.

These procedures can be done using either:

• laparoscopic (keyhole) surgery this involves inserting surgical instruments through tinycuts
• open surgerywhere a larger cut is made in your child's tummy

Speak to your surgeon about the best option for your child.

Risks of surgery

No surgery is risk-free. There's a small chance of:

• bleeding during or after the operation
• the bowel becoming infected (enterocolitis)
• bowel contentsleaking into the body, which could lead to serious infection (peritonitis) if not treated quickly

• the bowel becoming narrowed or blocked again, requiring further surgery

Recovery from surgery

Your child will probably need to stay in hospital for a few days after surgery. They'll be givenpain-relieving medicine to make them comfortable and fluids into a vein until they can manage food.

No special diet is needed once you get home, but it's important they drink plenty of fluids as they recover.

Your child should recover well and theirbowels should function normally after surgery.

At first they'll probably have a sore bottom when they poo.It can help to leave their bottom open to the air whenever possible, anduse baby oil to gently clean their bottom as well asnappy cream after each change.

Call your doctor immediately if your child develops problems such as a swollen belly, fever, or foul-smelling diarrhoea.