Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.
Hirschsprung disease is treated with surgery called a pull-through procedure. A surgeon removes the part of the large intestine that lacks nerve cells. When possible, the healthy part that is left is connected to the anal opening.
In some cases, surgery may be done in two stages. A child who is very sick from Hirschsprung disease may first need ostomy surgery. This can help the child heal before the pull-through surgery. With ostomy surgery, the diseased part of the large intestine is removed. The end of the healthy intestine is moved to an opening made in the belly. This opening is called a stoma. Stool passes through the stoma and into a bag worn outside the body. The bag must be emptied several times a day.
An ostomy may be short-term or temporary. Or it may be permanent. It depends on how much of the intestine must be removed. If it is short-term, the surgeon will connect the healed intestine to the anus and sew the stoma (opening) closed.
In most cases, the ostomy is temporary. But sometimes children with Hirschsprung disease must have a permanent ostomy. Infants will feel better after ostomy surgery because they will be able to pass gas and stool easily.
While older children will feel better as well, they must adjust to living with a permanent ostomy. This means learning how to take care of the stoma and how to change the ostomy pouch. Living with an ostomy can be very hard. A special nurse, called an ostomy nurse, can help your child learn how to care for the ostomy. The nurse can also provide emotional support and encouragement.
A colostomy is a surgical procedure that creates an opening for the colon, or large intestine to excrete waste in a small bag located outside of the body. Most babies born with an anorectal malformation will need a temporary colostomy within the first few days of life. The colostomy will ensure the baby can properly pass stool, helps to normalize digestion and greatly reduces the risk of infection.
If your child has a malformation of the large intestines that interferes with waste existing the body, an ileostomy may be performed. an ileostomy involves connecting a part of the small intestine to a surgical opening in the abdomen that allows feces to move outside of the body into a small pouch. This provides a temporary solution for stool to exit until your child is ready to undergo reconstructive surgery. Once the ileostomy is no longer needed, surgery will be performed to connect the large and small intestine.