Th. Diseth et al., BOWEL FUNCTION, MENTAL-HEALTH, AND PSYCHOSOCIAL FUNCTION IN ADOLESCENTS WITH HIRSCHSPRUNGS-DISEASE, Archives of Disease in Childhood, 76(2), 1997, pp. 100-106
Congenital intestinal malformations are uncommon and may pose lasting
somatic difficulties. Patients with anorectal anomalies have a high fr
equency of persistent faecal dysfunction and psychosocial problems. Th
is study examined whether adolescents with Hirschsprung's disease have
more psychosocial problems than their healthy peers. Nineteen adolesc
ents (mean age 15.7 years) with Hirschsprung's disease were assessed f
or bowel function, anorectal physiology, mental health, and psychosoci
al functioning by physical examinations, semistructured interview, and
standardised questionnaires. The adolescents were compared with contr
ols. The parents of 13 adolescents with Hirschsprung's disease were in
terviewed and completed questionnaires. Thirty two per cent of the ado
lescents with Hirschsprung's disease had significant impairment of con
tinence, but no more psychopathology (16%) nor psychosocial dysfunctio
n as a group than their healthy peers. Faecal incontinence was associa
ted with poorer psychosocial functioning and parental criticism. The f
act that a significant number of patients with Hirschsprung's disease
have incontinence into adulthood indicates the need for parental couns
elling, encouraging realistic expectations about continence.