BOWEL FUNCTION, MENTAL-HEALTH, AND PSYCHOSOCIAL FUNCTION IN ADOLESCENTS WITH HIRSCHSPRUNGS-DISEASE

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.