Bowel function and factors that affect outcome in children six months after definitive surgery for hirschsprung’s disease at Mulago hospital.

Abstract

Introduction. Hirschsprung’s disease is associated with long-term morbidity after definitive surgery. Evidence from literature in other settings has shown that bowel function following definitive surgery is still poor with the most common complications being; constipation, incontinence and Hirschsprung’s associated enterocolitis. Such evidence lacks in our setting. materials and methods: This was a retrospective review of children three to twelve years old operated for Hirschsprung’s disease and had stomas reversed in the period between January 2012 and May 2018. The pediatric surgery database that runs from January 2012 to date was used to obtain patient contact information. Postoperative bowel functional outcomes were assessed using the Rintala Bowel Function Score. Patient factors, caretaker factors and clinical factors were analyzed and compared with abnormal bowel function at bivariate and multivariate level to determine association. Results. In this study, there was a male: female ratio of 2.75:1. The main surgical technique used was the Swenson procedure. The bowel function outcomes were generally normal in 60% (27 participants) and abnormal in 40% (18 participants). The prevalence of constipation was 22.22% (10 participants), that of fecal incontinence was 20% (9 participants) and there were no cases of HAEC. Conclusion. Abnormalities of bowel function after definitive surgery for Hirschsprung’s disease are common in patients operated in the study area (Mulago national referral hospital). The main complications are constipation and fecal incontinence and having a female caretaker is associated with better outcomes.