Children who have difficulty defecating due to constipation, etc., may suffer from this disease

Congenital megacolon. Provided by Asan Medical Center, Seoul.

Congenital megacolon is a disease that causes symptoms such as constipation, vomiting, and abdominal distension because the bowel movement is not smooth and the stool cannot be pushed toward the anus. Also called ‘Hirschsprung’s disease’.

This disease is caused by the absence of intestinal ganglion cells involved in intestinal contraction and relaxation. About 80% of these ‘aganglia’ appear in the colon, the tip of the large intestine.

When food reaches the aganglia, where it cannot move through the intestines, it cannot move any more, and it stagnates and continues to accumulate. Then, the upper intestine in the affected area is stretched abnormally, causing megacolon symptoms.

According to the medical community on the 29th, congenital megacolon develops in about 1 in 5,000 people. Before birth, a specific problem cannot be found, but after birth, the bowel movement begins and symptoms appear.

Congenital megacolon is suspected if the meconium is not discharged within 24 hours or the abdomen is distended with vomiting. In addition, even if symptoms do not appear immediately after birth, symptoms such as persistent constipation, green vomiting, and abdominal discomfort may appear around 3 months after birth.

If the lesion site without enteric ganglion cells is short, it may not show any special symptoms in newborns and may not appear until 2-3 years of age. If the symptoms of constipation are mild, you can have a bowel movement even a small number of times. Because of this, if the child’s constipation is severe, it is necessary to suspect congenital megacolon at least once.

If the treatment time is missed, gas and feces may continuously accumulate in the intestine, leading to bacterial growth and enteritis. In severe cases, it can progress to sepsis, which can be life-threatening, so early detection and treatment are essential.

Surgery is essential for the treatment of congenital megacolon. Surgery is performed in consideration of the location and length of the lesion without intestinal ganglion cells and the condition of the patient.

Most cases where the aganglia are located in the colon can be cured with one operation. However, if the aganglia are located above the colon, the operation may be more complicated. In some cases, more than one operation may be required.

Management of bowel disorders after surgery is even more important. This is because even children who have undergone surgery may experience constipation or constipation more easily than normal children. Therefore, it is necessary to regularly consult a specialist through an outpatient clinic after surgery.

Professor Oh Chae-yeon of the Department of Pediatrics at Korea University Ansan Hospital said, “Constipation is a common defecation disorder, so even if a child shows persistent constipation symptoms, it is overlooked.” “I need to see a pediatric surgeon,” he said.

Professor Oh said, “Congenital megacolon is a curable disease and the surgical prognosis is very good. It is necessary to suspect the disease at some point,” he advised.

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