Hirschsprung’s Disease: An Overview

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Hirschsprung’s disease is a congenital condition that affects the large intestine. Here’s what you need to know. 

Causes and Risk Factors

Hirschsprung’s disease occurs when a baby is born missing nerve cells in their colon. Due to these missing nerve cells, they develop issues passing stool. While we do know that it’s a condition people are born with, the exact cause is not known. In some cases, it does occur in families. In fact, if one parent has the condition, their child has an increased chance of having the condition as well. In families with a child that has Hirschsprung’s disease, there’s between a 3% and 12% chance that if the parents have another baby, the baby will have the condition. 

Being a male is another risk factor for the condition. People with inherited conditions like Down’s syndrome and congenital heart disease are also at a higher risk of Hirschsprung’s disease. 

Symptoms

This condition can vary in severity, and as such so can its symptoms. In general, symptoms tend to appear right after birth. One well-known sign of the condition is if a newborn is unable to have a bowel movement within 48 hours of being born. Other common symptoms include diarrhea, vomiting a green or brown substance, constipation, gas, and a swollen belly. Newborns are likely to be fussy if they have some of these symptoms. Older children with the condition can have some of the same symptoms, and others including fatigue, chronic constipation, and a failure to thrive. 

Diagnosing Hirschsprung’s Disease

As noted before, one key sign your child could have this condition is if they are unable to have a bowel movement in the first couple of days after birth. Your doctor will also perform a physical exam to check the child’s condition. They can perform a number of other tests as well. They can take a biopsy, a tissue sample, of your child’s colon to send off for lab testing to determine if there are nerve cells present or not. They can also insert contrast dye into your child’s bowel and perform an X-ray to visualize their colon. They can then check to see if there is a narrow section of the bowel (a section without nerves) and a swollen section behind it, a sign of Hirschsprung’s disease. 

Treatment

The most common way doctors treat this condition is through surgery. The pullthrough procedure is the most common approach, and can be done in a few ways. Ultimately, doctors first work to remove the abnormal part of the colon. They then attach the healthy section of the colon to the anus. Today, this is most often done through a laparoscopic surgery which is minimally invasive and results in fewer complications for children with the condition. The surgery leads to very positive outcomes in the majority of cases, and can fully treat the condition. 

There are some potential complications from surgery. Children can experience diarrhea, fecal incontinence, a delay in toilet training, and constipation. In some cases, these complications resolve over time. Children who have had this surgery are also at a higher risk of a bowel infection up to a year after the surgery. 

Our experienced team at GHP has years of experience treating patients with various GI conditions including Hirschsprung’s Disease. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

Fecal Incontinence

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Fecal incontinence is a condition in which you are unable to control bowel movements. Here’s what you need to know. 

Causes and Risk Factors

Many things can cause fecal incontinence, and may occur in combination. For example, nerve damage in the rectum or anal sphincter, which can occur during childbirth, may be a cause. Muscle damage in the anal sphincter, also possible during childbirth, may prevent you from being able to hold stool back. Diarrhea can also be a cause, as loose stool is more difficult to retain in the rectum. Other potential causes include aging, hemorrhoid surgery, rectal prolapse, and IBS. 

Risk factors for fecal incontinence include being older than 65, being female, having late-stage dementia or Alzheimer’s, having a condition that causes nerve damage, and having a physical disability. If more than one of these apply to you, you have a heightened risk of developing the condition. 

Symptoms of Fecal Incontinence

With fecal incontinence, you are unable to control bowel movements. In some cases, this may be temporary due to having diarrhea, while in other cases it may be a chronic condition. Urge incontinence is one type of the condition, in which you may feel the sudden urge to defecate and are unable to control your bowels. In another case, called passive incontinence, you may not feel the urge to pass stool and pass it unknowingly. Fecal incontinence can be accompanied by other symptoms like diarrhea, gas, constipation, and bloating. 

Often times, people feel emotional distress as a result of having fecal incontinence. They are often reluctant to tell their doctor about the condition due to the social taboo around it. If you do experience fecal incontinence, please talk to your doctor- they can help you manage the condition. 

Diagnosis

Your doctor can diagnose fecal incontinence in several ways. They will start out by asking you about your symptoms and medical history, before performing a visual exam. Your doctor will likely visually examine your anus first. They can also perform a digital rectal exam, whereby they evaluate the strength and coordination of your sphincter muscles. They can also perform an anal manometry test to evaluate the function of your rectum. To visualize your sphincter and rectum, they can also perform other tests like a colonoscopy, an MRI, or anorectal ultrasonography. 

Treatment 

Doctors treat fecal incontinence based on what is causing the condition in your case. If there is a particular food that is causing diarrhea and incontinence, they will help you work to identify and remove it from your diet. If you have diarrhea or constipation, your doctor may recommend increasing your fiber intake through your diet or through supplements. They may also recommend bowel training if muscle damage is at play; here, you will work to exercise and strengthen the affected muscles to help you better control bowel movements. 

In some cases, you may need surgery. Doctors can perform a number of procedures to help repair muscle damage, nerve damage, and other underlying causes of incontinence. 

Our experienced team at GHP has years of experience treating patients with various GI conditions including fecal incontinence. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

COVID-19 and the GI System

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Back in August 2020, we first explored how a COVID-19 infection could affect your GI system. There was very little data to work with at the time, as the pandemic was largely still unfolding across the United States and across the world. 

Since then, much has happened with the pandemic. Now, at a time when vaccinations are widespread in the United States, case counts are ever decreasing, and more of the country starts to open back up, we’re going to take another look at the evidence around COVID-19 and its effects on the GI system. Here’s what the best evidence shows today. 

GI Symptoms in People with COVID-19

Over the past year and a half or so, well over 100 million people around the world have gotten the coronavirus. Researchers have been able to perform numerous studies to examine different aspects of the disease and its impact on communities globally. One study published in September 2020 found that 53% of people hospitalized with COVID-19 experienced at least one GI symptom. 

In our previous post on COVID-19, we noted that research on COVID-19 patients who were ill in March and April of 2020 found several common symptom clusters. One of these clusters was primarily characterized by GI symptoms, and several others included GI symptoms. 

Disease Outcomes when GI Symptoms are Present

An emergent insight from the past year and a half of research is that people with COVID-19 who have GI symptoms seem to be more likely to have more severe disease outcomes. A number of different studies, each focusing on different populations, have found the following: 

Why COVID-19 Causes GI Symptoms

Clearly, the coronavirus attacks the body in a way that implicates the GI system. Scientists have learned more about exactly how this happens, and thus why GI symptoms seem to be fairly common and significant. 

The coronavirus infiltrates cells in the intestine through the ACE-2 receptor, which is a protein in cell membranes. The virus’ spike proteins bind to this receptor and enter the cell. Once in the cell, the virus reproduces itself. When it leaves infected cells, it causes a release of cytokines, proteins that help fight inflammation in your body. When the virus causes too many cytokines to be released, they can damage your GI system and cause symptoms. The coronavirus can also attack your GI system directly in other ways. It may damage tissues, disrupt your gut microbiota, and impact your vagus nerve (which can lead to nausea).   

We hope this overview sheds some light on the recent discoveries of how COVID-19 impacts the GI system.

Our experienced team at GHP has years of experience treating patients with various GI conditions. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.

 

Your Gut Health

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A healthy digestive system can help you prevent many conditions, and reduce their severity if you do get them. While there are a lot of factors in your individual case that can impact specific advice, there are some general principles that are good to follow in most cases. Here are some important ways you can improve your gut health. 

Food

A lot of gut health starts with what you eat. The advice here is likely something you’ve heard before. Eat fresh fruits and vegetables regularly, and make sure you are eating enough fiber. Fruits and veggies help with the fiber issue, as they provide a good amount of fiber to build healthy bacteria in your gut. Nuts, legumes (think lentils and beans), and seeds are also great sources of fiber and protein as well. 

You should try to avoid red meat, substituting chicken or fish instead, or even going for a vegetarian alternative like tofu. Avoid charred meats as well, which can harm your GI health. Fried foods are also have a negative impact on your gut health. You should additionally moderate your consumption of alcohol and caffeine, as too much of either can be detrimental. 

Probiotics for Gut Health

On the topic of diet and nutrition, you should also be aware of an important ally in your quest for gut health: probiotics. Probiotics are living microorganisms that help your body improve and restore healthy bacteria in your gut. Regularly consume foods with probiotics to help your healthy bacteria flourish. You can find probiotics in foods like yogurt, fermented vegetables, and cottage cheese. Of course, in some cases probiotics may not be the right choice, particularly if you have a condition that weakens your immune system. Make sure to talk to your doctor about how to healthily incorporate probiotics in your diet. 

Exercise, Sleep, and Stress Management

Another piece of the puzzle for gut health is another evergreen health concept: exercise. Regular exercise helps your body in numerous ways. In terms of gut health, it’s particularly helpful for two potential risk factors for gut issues: weight and stress. Exercise is a great, sustainable way to maintain a healthy weight and manage stress. You can work to manage stress in other ways as well. You might consider meditation, relaxation therapy, or other techniques that are proven to help manage stress levels. 

One last key factor for gut health is sleep. Here, like with exercise, it comes back to maintaining a healthy weight. People who do not get adequate sleep are at a higher risk of obesity, which can lead to negative outcomes for gut health. Healthy sleep is multifaceted. In general, you should make sure you have a regular schedule for when you go to sleep and wake up. There are many other steps you can take to improve your sleep hygiene as well.

Our experienced team at GHP has years of experience treating patients with various GI conditions. We can help establish the best plan of care for your situation. Contact any of our office locations to learn about the options we offer and schedule an appointment today.