Until last week, I had never ever heard of Hirschprung’s disease. After checking online for “ileus vs. bowel obstruction” (which were the original diagnoses considered), I started seeing it in the search results, but didn’t read anything in depth until a surgeon mentioned Hirschprung’s disease later.
Hirschprung’s disease is when the ganglion nerve cells inside the colon are missing, preventing the mobility of the colon’s muscles to move waste out of the body. Basically, it affects the colon from the end into the body. According to the Mayo Clinic, it is more common in males, it can be genetic (and with our girls’ histories of constipation, I’m wondering if they haven’t had it to some degree, too!), and is associated with other medical conditions.
It typically shows up – according to our surgeon – once a baby begins eating solid foods. According to this article, it may be possible to diagnose if a newborn has not stooled within 48 hours of birth. Little Man had two, one almost immediately after birth, so it was harder to catch for him… Although he did have some odd routines and had some constipation throughout his first 4 months.
If a baby is breastfeeding, or even given formula, typically the body can still move it through the digestive system without serious problem. But once a solid food is introduced – be it rice cereal, fruits, or vegetables – it tends to show up.
In our case, it was likely the rice cereal that was added to a few of Little Man’s formula bottles a few weeks ago…
Surgery is the correction for this issue. The portion of colon that is missing the necessary nerve cells is removed and then the good part that remains is reconnected to the end, and typically resolves the situation completely. This is not always the case, but like our surgeon said – 90% of the cases he’s seen are resolved entirely.
Obviously, some dietary restraints will need to be considered. Because cow’s milk protein allergy was also a possible diagnosis, and because Curly has had some issues with milk, we are going to be careful about the amount of cow’s milk our kids consume. Georgie has never really liked milk. But Curly LOVES it – and when she drinks it, she tends to get a swollen belly and starts having problems with constipation. My guess is that she has a smaller portion of colon affected by this same disease only she is older now and can manage herself better. Medications like Miralax, as well as suppositories and enemas, always worked for her, so if she does have the same disease, we don’t really know…
I’m not a doctor, but I’m just making some intuitive guesses here.
Kids who have an allergy to cow’s milk, also often have an allergy to soy, so we will just be careful about what we use from now on. We may switch from milk to almond or rice milk and see how that works. They don’t consume that much anymore – but it’s the stuff like cheese, sour cream, yogurt, and butter that concerns me – but we will do what is needed so they don’t suffer.
We still have to wait for post-operative results to see how Little Man might do – and then proceed with making changes as necessary. We have already been encouraging the girls to drink a big bottle of water everyday – and that will continue. We are praying for a surgery sooner rather than later, and no additional complications for him.
I’m not scared about his surgery. My youngest brother had to have surgery as a younger infant (for pyloric stenosis), and I was old enough to remember it. It was scary at the time, of course, and I will be nervous about the surgery going well without complications. What I mean to say is, that God has really given me a sense of peace about all of this. Little Man belongs to the Lord – and God is very aware of these things in his life. His hands fashioned Little Man, and His hands can guide the surgeon through the operation. And He will also carry us through whatever comes in Little Man’s life.